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General NPI Number Information
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NPI Number | 1548817562
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Entity Type | Organization
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Legal Business Name | SMD MEDSERVICES LLC
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 201 NW 82ND AVE 305
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City | PLANTATION
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State | FL
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Zip | 33324-2401
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Country | US
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Telephone | 786-314-1318
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Fax |
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Provider Business Mailing Address
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Address Line | 4148 SW 130TH AVE
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City | DAVIE
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State | FL
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Zip | 33330-4716
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GIEZY SARDINAS
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Credential | M.D
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Telephone | 786-314-1318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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