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General NPI Number Information
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NPI Number | 1760442677
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Entity Type | Organization
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Legal Business Name | STEPHEN E SMITH MD PA
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 4225 EVANS AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-9311
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Country | US
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Telephone | 239-936-7685
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Fax | 239-936-8683
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Provider Business Mailing Address
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Address Line | 4225 EVANS AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-9311
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Country | US
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Telephone | 239-936-7685
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Fax | 239-936-8683
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MEGHAN LIGHTHALL
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Credential |
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Telephone | 239-939-0413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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