Provider Demographics
NPI:1366681892
Name:SMITH, CHRISTOPHER JACOB (DO)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JACOB
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4300 N UNIVERSITY DR STE C100
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6243
Mailing Address - Country:US
Mailing Address - Phone:954-314-7671
Mailing Address - Fax:954-900-2372
Practice Address - Street 1:4300 N UNIVERSITY DR STE C100
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-6243
Practice Address - Country:US
Practice Address - Phone:954-314-7671
Practice Address - Fax:954-900-2372
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY251824207N00000X, 207Q00000X
FLOS10662207Q00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine