Healthcare Provider Details

I. General information

NPI: 1992971634
Provider Name (Legal Business Name): DAVID MATTHEW SMITH DO, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 08/04/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6TH MEDICAL GROUP 3250 ZEMKE AVENUE
MACDILL AFB FL
33621
US

IV. Provider business mailing address

6TH MEDICAL GROUP 3250 ZEMKE AVENUE
MACDILL AFB FL
33621
US

V. Phone/Fax

Practice location:
  • Phone: 813-827-9899
  • Fax:
Mailing address:
  • Phone: 813-827-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS10463
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberUO1747
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberOS10463
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: