| Doc Smith | |
|
6060 State Road 70 E Unit D Bradenton FL 34203-9719 | |
| (941) 782-8529 | |
| Not Available |
| Full Name | Doc Smith |
|---|---|
| Speciality | Internal Medicine |
| Location | 6060 State Road 70 E Unit D, Bradenton, Florida |
| Authorized Official Name and Position | Rubena Smith (OWNER) |
| Authorized Official Contact | 9178482701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doc Smith 6060 State Road 70 E Unit D Bradenton FL 34203-9719 Ph: (941) 782-8529 | Doc Smith 6060 State Road 70 E Unit D Bradenton FL 34203-9719 Ph: (941) 782-8529 |
| NPI Number | 1992402499 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 10/20/2026 |
| Certification Date | 10/20/2026 |
| Medicare PECOS PAC ID | 1557724499 |
|---|---|
| Medicare Enrollment ID | O20230825000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992402499 | NPI | - | NPPES |
| 108952300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Rubena J Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649687567 PECOS PAC ID: 5092089920 Enrollment ID: I20201216000256 |
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