Provider Demographics
NPI:1811977333
Name:SMITH, JAMES O (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:O
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3000 MEDICAL PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4696
Mailing Address - Country:US
Mailing Address - Phone:813-615-8088
Mailing Address - Fax:813-615-8468
Practice Address - Street 1:3000 MEDICAL PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4696
Practice Address - Country:US
Practice Address - Phone:813-615-8088
Practice Address - Fax:813-615-8468
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048314207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30898OtherBCBS
FL061551000Medicaid
FL60046957OtherMEDICARE RAILROAD
FL2500134OtherUNITED HEALTHCARE
FL202371OtherAVMED
FL4047765OtherAETNA
FL202371OtherAVMED
FL30898OtherBCBS