MEDICARE: MICHAEL DAVID 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	2085R0001X	Radiation Oncology Physician	TL3100	WY
2	2085R0001X	Radiation Oncology Physician	01036913A	IN
3	2085R0001X	Radiation Oncology Physician	H5682	TX
4	2085R0001X	Radiation Oncology Physician	MD60295642	WA
5	2085R0001X	Radiation Oncology Physician	021562	TN
6	2085R0001X	Radiation Oncology Physician	103176	FL
7	2085R0001X	Radiation Oncology Physician	MD-9852	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5104065	OTHER	FL	AETNA
2	P116158	OTHER	FL	FREEDOM HEALTH
3	1459L	OTHER	FL	BCBS FL
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	P306917	OTHER	FL	OPTIMUM
6	10L838	OTHER	FL	HEALTHY KIDS THRU COMMUNITY HEALTH PARTNERS
7	6067119	OTHER	FL	CIGNA
8	P01174095	OTHER	FL	RAILROAD MCR
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	364004	OTHER	FL	AVMED
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902835374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DAVID SMITH M.D.

Provider Business Mailing Address
First Line	:	1420 CELEBRATION BLVD STE 308
Second Line	:
City	:	CELEBRATION
State	:	FL
Zip	:	34747-5161
Country	:	US
Telephone Number	:	407-599-9899
Fax Number	:	305-946-1029

Provider Business Practice Location Address
First Line	:	40107 HIGHWAY 27
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-5901
Country	:	US
Telephone Number	:	863-419-0692
Fax Number	:	863-419-1695

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	04/01/2024

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Directions to “ MICHAEL DAVID SMITH M.D.” Practice Location

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