Provider Demographics
NPI:1457316028
Name:SMITH, ROBERT SCOTT (ARNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SCOTT
Last Name:SMITH
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 ARLINGTON ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3507
Mailing Address - Country:US
Mailing Address - Phone:941-917-4250
Mailing Address - Fax:941-917-4257
Practice Address - Street 1:1950 ARLINGTON ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3507
Practice Address - Country:US
Practice Address - Phone:941-917-4250
Practice Address - Fax:941-917-4257
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2730412363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y01M4OtherBCBS
FL000714600Medicaid
Y01M4OtherBCBS
E65272Medicare ID - Type Unspecified