Healthcare Provider Details

I. General information

NPI: 1548559081
Provider Name (Legal Business Name): ELLIOT Z SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 E HIGH ST STE 203
CHARLOTTESVILLE VA
22902-4849
US

IV. Provider business mailing address

9200 S DADELAND BLVD STE 800
MIAMI FL
33156-2758
US

V. Phone/Fax

Practice location:
  • Phone: 434-817-8484
  • Fax: 434-817-8490
Mailing address:
  • Phone: 786-530-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101255764
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101255764
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101255764
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: