MEDICARE: DR. RICHARD C SMITH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME61685	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2079653	OTHER		AETNA PPO
2	18423	OTHER	FL	BCBS-FL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033213749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD C SMITH M.D.

Provider Business Mailing Address
First Line	:	7575 DR PHILLIPS BLVD STE 370
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7220
Country	:	US
Telephone Number	:	407-292-2156
Fax Number	:	866-777-3096

Provider Business Practice Location Address
First Line	:	7575 DR PHILLIPS BLVD STE 370
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7220
Country	:	US
Telephone Number	:	407-292-2156
Fax Number	:	866-777-3096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	01/08/2025

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