| Matthew G Smith Md Pa | |
|
2105 Tyrone Blvd N St Petersburg FL 33710-4023 | |
| (727) 823-3022 | |
| (727) 343-6775 |
| Full Name | Matthew G Smith Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2105 Tyrone Blvd N, St Petersburg, Florida |
| Authorized Official Name and Position | Matthew G Smith (PRESIDENT) |
| Authorized Official Contact | 7278233022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew G Smith Md Pa 2105 Tyrone Blvd N St Petersburg FL 33710-4023 Ph: (727) 823-3022 | Matthew G Smith Md Pa 2105 Tyrone Blvd N St Petersburg FL 33710-4023 Ph: (727) 823-3022 |
| NPI Number | 1679796627 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 09/20/2007 |
| Medicare PECOS PAC ID | 6103859269 |
|---|---|
| Medicare Enrollment ID | O20050919000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679796627 | NPI | - | NPPES |
| 273475300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME90555 (Florida) | Primary |
| Provider Name | Matthew G Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235121724 PECOS PAC ID: 3072577659 Enrollment ID: I20041113000143 |
| Provider Name | Jennifer Jonell Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558530253 PECOS PAC ID: 9133345945 Enrollment ID: I20230327002144 |
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