Provider Demographics
NPI:1861658247
Name:SMITH, BRIAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8340 COLLIER BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-3626
Mailing Address - Country:US
Mailing Address - Phone:239-348-4221
Mailing Address - Fax:239-354-6398
Practice Address - Street 1:8340 COLLIER BLVD
Practice Address - Street 2:STE 309
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114
Practice Address - Country:US
Practice Address - Phone:239-348-4221
Practice Address - Fax:239-354-6398
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245118208600000X
FLME122232208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery