| Renaldas Algirdas Smidtas | |
|
413 5th Ave Nw Jasper FL 32052-7800 | |
| (386) 792-0753 | |
| Not Available |
| Full Name | Renaldas Algirdas Smidtas |
|---|---|
| Speciality | Internal Medicine |
| Location | 413 5th Ave Nw, Jasper, Florida |
| Authorized Official Name and Position | Renaldas A Smidtas (OWNER) |
| Authorized Official Contact | 3867920753 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaldas Algirdas Smidtas 413 Nw 5th Ave Jasper FL 32052 Ph: (386) 792-0753 | Renaldas Algirdas Smidtas 413 5th Ave Nw Jasper FL 32052-7800 Ph: (386) 792-0753 |
| NPI Number | 1104097963 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 06/30/2011 |
| Medicare PECOS PAC ID | 4688852254 |
|---|---|
| Medicare Enrollment ID | O20110630000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104097963 | NPI | - | NPPES |
| 103986 | Other | FL | AVMED |
| 110117134 | Other | RAILROAD MEDICARE | |
| 27984 | Other | FL | BCBS |
| 378783400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME0069486 (Florida) | Primary |
| Provider Name | Renalds A Smidtas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568571263 PECOS PAC ID: 1052599628 Enrollment ID: I20110630000018 |
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