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1790064863

NPI Code Detail

MEDICARE: DR. CHRISTOPHER A SMITH MD

MEDICARE: DR. CHRISTOPHER A SMITH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	ME116422	FL
2	208D00000X	General Practice Physician	ME116422	FL
3	207R00000X	Internal Medicine Physician	ME116422	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790064863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER A SMITH MD

Provider Business Mailing Address
First Line	:	7620 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-8223
Country	:	US
Telephone Number	:	321-235-0692
Fax Number	:	321-235-0694

Provider Business Practice Location Address
First Line	:	7620 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-8223
Country	:	US
Telephone Number	:	321-235-0692
Fax Number	:	321-235-0694

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2011
Last Update Date	:	10/20/2021

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Directions to “ DR. CHRISTOPHER A SMITH MD” Practice Location

Language	Start Address	Practice Location

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