Frederick Raymond Smith Jr., MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME 0030862 Issued in FL

Practice address

3945 Pinetop Blvd
Titusville, FL 32796-3636

Phone

(321) 267-5396

NPI assigned

Jan 23, 2009

Last updated

Jan 23, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1225276553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 PINETOP BLVD",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963636",
            "telephone_number": "321-267-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 PINETOP BLVD",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963636",
            "telephone_number": "321-267-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "FREDERICK",
        "middle_name": "RAYMOND",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME 0030862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048420200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sister 2 Sister Home Care
• Angela Jo Ann Skroch
• Stephen Slade, DDS
• Annmarie Slater, LPN
• Charles A Slattery, MD
• Jessica L Smith, LMHC
• Stephanie D Smith
• Steven Louis Smith, D.C.
• Jaime Brooke Smyth
• Mohamed Aly Soliman

• Anesthesiology Physician in Titusville, FL
• Providers in Titusville, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.