Provider Demographics
NPI:1437138195
Name:SMITH, DENNIS M (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4204
Mailing Address - Country:US
Mailing Address - Phone:561-712-6265
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:3599 UNIVERSITY BLVD S
Practice Address - Street 2:SUITE 1700
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4252
Practice Address - Country:US
Practice Address - Phone:904-858-0110
Practice Address - Fax:904-858-7020
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0045441207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD61845Medicare UPIN