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General NPI Number Information
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NPI Number | 1346669025
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Entity Type | Individual
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Provider Name | GERDIE JEAN-SMITH M.D,
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Gender | Female
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 2525 HARBOR BLVD STE 308
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5344
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Country | US
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Telephone | 941-629-7777
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Fax | 941-629-8170
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Provider Business Mailing Address
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Address Line | 2525 HARBOR BLVD STE 308
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5344
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Country | US
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Telephone | 941-629-7777
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Fax | 941-629-8170
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 50683
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R3520
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME136348
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 50683
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME136348
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 50683
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME136348
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License Number State | FL
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