Provider Demographics
NPI:1285741850
Name:SMART, KIERAN T (MBCHB MPH MSC MRCGP)
Entity type:Individual
Prefix:DR
First Name:KIERAN
Middle Name:T
Last Name:SMART
Suffix:
Gender:M
Credentials:MBCHB MPH MSC MRCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 SANTA MARIA ST # F437
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-1851
Mailing Address - Country:US
Mailing Address - Phone:281-744-8535
Mailing Address - Fax:
Practice Address - Street 1:220 SANTA MARIA ST # F437
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-1851
Practice Address - Country:US
Practice Address - Phone:281-744-8535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97982207P00000X, 207Q00000X
TXM2817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF442YMedicare PIN
TXH65357Medicare UPIN