Individual provider Active NPI

Reynaldo Pezzotti Smith, M.D

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1508093154
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1037 Issued in FL
Practice address
3822 Broadway
Fort Myers, FL 33901-8148
Phone
(239) 900-9170
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 17615 PR
Family Medicine Physician 207Q00000X 1037 FL Primary

Addresses

Primary practice location

3822 Broadway
Fort Myers, FL 33901-8148

Mailing address

3024 Seafarer Dr
Punta Gorda, FL 33983-3457
Phone (407) 820-7079

Other practice location 1

Ciudad Jardin 1, #117 Anthurium st.
Toa Alta,P.R.
Toa Alta, PR 00953-4844
Phone (787) 646-5905

Other practice location 2

156 Via De La Ermita
Caguas, PR 00727-3101
Phone (407) 820-7079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101208001065 PR Practitioner - General Practice 0648467258 Practice locations: San Juan, PR
I20200629001591 FL Practitioner - General Practice 0648467258 Reassigns benefits to 1 organization
Practice locations: Clermont, FL

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sante Plus Medical CenterGroup PAC ID 8123420049, 9 clinicians

Practice addresses (Care Compare)

1502 Lake Trafford Rd
Immokalee, FL 34142-2618
Phone (239) 722-6774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1037FLMDFamily Medicine Physician
17615PRMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sante Plus Medical Center Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Solution Medical Group Current Accepting new patients
Sante Plus Medical Center Past Accepting new patients

Locations

3900 Broadway
Ste C
Fort Myers, FL 33901
Phone (239) 936-4494

3822 Broadway
Ste A
Fort Myers, FL 33901
Phone (239) 274-3004

1900 Nebraska Ave
Ste 1
Fort Pierce, FL 34950
Phone (772) 464-3200

1502 Lake Trafford Rd
Immokalee, FL 34142
Phone (239) 657-6363

3400 Lee Blvd
Ste 102
Lehigh Acres, FL 33971
Phone (239) 893-4141

8360 Sierra Meadows Blvd
Naples, FL 34113
Phone (239) 403-6375

3155 Lake Worth Rd
Palm Springs, FL 33461
Phone (561) 439-8440

10616 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 224-2467

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1508093154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 SEAFARER DR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339833457",
            "telephone_number": "407-820-7079",
            "fax_number": "787-961-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3822 BROADWAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018148",
            "telephone_number": "239-900-9170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Ciudad Jardin 1, #117 Anthurium st.",
            "address_2": "Toa Alta,P.R.",
            "address_purpose": "LOCATION",
            "city": "Toa Alta",
            "state": "PR",
            "postal_code": "009534844",
            "country_code": "US",
            "telephone_number": "787-646-5905",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "156 Via De La Ermita",
            "address_purpose": "LOCATION",
            "city": "Caguas",
            "state": "PR",
            "postal_code": "007273101",
            "country_code": "US",
            "telephone_number": "407-820-7079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEZZOTTI SMITH",
        "first_name": "REYNALDO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "PR",
            "license": "17615",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "1037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.