MEDICARE: VICTORIA L. 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	207Q00000X	Family Medicine Physician	ME76824	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00307759	OTHER	FL	RAIL ROAD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811938442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA L. SMITH M.D.

Provider Business Mailing Address
First Line	:	2915 KERRY FOREST PKWY STE 103
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-7803
Country	:	US
Telephone Number	:	850-907-0097
Fax Number	:	850-325-6013

Provider Business Practice Location Address
First Line	:	2915 KERRY FOREST PKWY
Second Line	:	SUITE 103
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-7802
Country	:	US
Telephone Number	:	850-907-0097
Fax Number	:	850-325-6013

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	02/25/2025

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