Provider Demographics
NPI:1497762140
Name:SMITH, RONALD N (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:N
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9117
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11555-9117
Mailing Address - Country:US
Mailing Address - Phone:800-910-9207
Mailing Address - Fax:
Practice Address - Street 1:1395 STATE ROAD 7
Practice Address - Street 2:SUITE 100
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-9326
Practice Address - Country:US
Practice Address - Phone:561-422-1950
Practice Address - Fax:561-422-0997
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64206207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F70559Medicare UPIN
FL23621Medicare ID - Type Unspecified