Provider Demographics
NPI:1457370884
Name:SMITH, ROBERT LEWIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEWIS
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:9332 STATE ROAD 54
Mailing Address - Street 2:STE 202
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1810
Mailing Address - Country:US
Mailing Address - Phone:727-849-1659
Mailing Address - Fax:727-842-3627
Practice Address - Street 1:9332 STATE ROAD 54
Practice Address - Street 2:STE 202
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1810
Practice Address - Country:US
Practice Address - Phone:727-849-1659
Practice Address - Fax:727-842-3627
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2015-12-14
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Provider Licenses
StateLicense IDTaxonomies
FLME0074072207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE0127ZOtherMEDICARE
FL252741300SMedicaid
FLG63600Medicare UPIN