Provider Demographics
NPI:1548431315
Name:SMITH, SANJAY NEDAL (MD)
Entity Type:Individual
Prefix:MR
First Name:SANJAY
Middle Name:NEDAL
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5858 SW 68TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3693
Mailing Address - Country:US
Mailing Address - Phone:305-661-8588
Mailing Address - Fax:305-661-4906
Practice Address - Street 1:5858 SW 68TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3693
Practice Address - Country:US
Practice Address - Phone:305-661-8588
Practice Address - Fax:305-661-4906
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 119977207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology