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General NPI Number Information
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NPI Number | 1548130768
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Entity Type | Organization
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Legal Business Name | ONE MIAMI MEDICAL, LLC
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 4770 BISCAYNE BLVD STE 680
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City | MIAMI
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State | FL
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Zip | 33137-3244
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Country | US
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Telephone | 786-529-6172
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Fax |
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Provider Business Mailing Address
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Address Line | 685 NE 59TH ST
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City | MIAMI
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State | FL
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Zip | 33137-2362
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Country | US
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Telephone | 786-529-6172
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Fax | 305-506-4387
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAUN DANE VILLIERS SMITHSON
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Credential | MD
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Telephone | 832-799-4493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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