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Practitioner Profile

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TRAVIS MICHAEL SMITH

License Number: OS11602

Profession: Osteopathic Physician
License Status: CLEAR/Active
Year Began Practicing: 09/01/2011
License Expiration Date: 03/31/2026
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain): Yes

Primary Practice Address

TRAVIS MICHAEL SMITH

238 Canal Blvd

Suite 2

PONTE VEDRA BEACH, FL 32082

Medicaid

This practitioner DOES participate in the Medicaid program.

Staff Privileges

This practitioner currently holds staff privileges at the following hospital/medical/health institutions:


Institution Name	City	State
ST. VINCENT'S MEDICAL CENTER	JACKSONVILLE	FLORIDA

Email Address

Please contact at: travis.smith@lecom.edu

Other State Licenses

This practitioner has indicated the following additional state licensure:


State	Profession
Georgia	Osteopathic Physician

Florida Birth-Related Neurological Injury Compensation Association

If you are a Florida Allopathic (MD) or Osteopathic (DO) Physician, you are required to provide proof of payment of the Florida Birth-Related Neurological Injury Compensation Association (NICA) assessment as required by section 766.314, Florida Statutes. Payment of the initial and annual assessment are required of all Florida Allopathic and Osteopathic Physicians who do not qualify for an exemption as set forth in section 766.314(4)(b)4, Florida Statutes.

This practitioner has indicated that he/she has submitted payment of the assessment.

Specialty Certification

This practitioner holds the following certifications from specialty boards recognized by the Florida board which regulates the profession for which he/she is licensed:


Specialty Board	Certification
AMERICAN BOARD OF EMERGENCY MEDICINE	EM - EMERGENCY MEDICINE

Financial Responsibility

I have hospital staff privileges and I have obtained and maintain an unexpired, irrevocable letter of credit, established pursuant to chapter 675 FS, in an amount not less than $250,000 per claim, with a minimum aggregate availability of credit of not less than $750,000.The letter of credit shall be payable to the osteopathic physician as beneficiary upon presentment of a final judgment indicating liability and awarding damages to be paid by the osteopathic physician or upon presentment of a settlement agreement signed by all parties to such agreement when such final judgment or settlement is a result of a claim arising out of the rendering of, or the failure to render, medical care and services. Such letter of credit shall be nonassignable and nontransferable. Such letter of credit shall be issued by any bank or savings association organized and existing under the laws of this state or any bank or savings association organized under the laws of the United States that has its principal place of business in this state or has a branch office which is authorized under the laws of this state or of the United States to receive deposits in this state OR I have hospital staff privileges and I have established and maintain an escrow account consisting of cash or assets eligible for deposit in accordance with s.625.52 FS in the per-claim amounts specified above.

ARNP Protocol Documents