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RENALDAS SMIDTAS MD
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1568571263
Individual Registrant: RENALDAS SMIDTAS MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
413 NW 5TH AVE JASPER, FL 32052 US
Tel: 386-792-0753 Fax: 386-792-2412
Tel: 386-792-0753 Fax: 386-792-2412
Contact information for business:
413 NW 5TH AVE JASPER, FL 32052 US
Tel: 386-792-0753 Fax: 386-792-2412
Tel: 386-792-0753 Fax: 386-792-2412
Registration Information:
NPI: 1568571263
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | FL | ME0069486 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| AVMED | 103986 | FL | 01 |
| BLUE CROSS BLUE SHIELD | 27984 | FL | 01 |
| 378783400 | FL | 05 |
