Basic Information
Provider Information
NPI: 1215907431
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SMOLARSKI
FirstName: ALAIN
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4881 NW 8TH AVE
Address2: SUITE 2
City: GAINESVILLE
State: FL
PostalCode: 326054582
CountryCode: US
TelephoneNumber: 3523736338
FaxNumber: 3523736144
Practice Location
Address1: 910 OLD CAMP RD
Address2: SUITE 202
City: THE VILLAGES
State: FL
PostalCode: 321625604
CountryCode: US
TelephoneNumber: 3527536886
FaxNumber: 3527536532
Other Information
ProviderEnumerationDate: 01/23/2006
LastUpdateDate: 05/22/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME0075618FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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