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NPI Code Detail

MEDICARE: SAMUEL VAZQUEZ-MILAN PA-C

MEDICARE: SAMUEL VAZQUEZ-MILAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA9112274FL
2363AS0400XSurgical Physician Assistant7928GA
3363A00000XPhysician AssistantPA9112274FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255783114
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL VAZQUEZ-MILAN PA-C
Provider Business Mailing Address
First Line : 801 ANCHOR RODE DR STE 100
Second Line :
City : NAPLES
State : FL
Zip : 34103-2742
Country : US
Telephone Number : 239-263-1717
Fax Number : 239-403-9410
Provider Business Practice Location Address
First Line : 801 ANCHOR RODE DR STE 100
Second Line :
City : NAPLES
State : FL
Zip : 34103-2742
Country : US
Telephone Number : 239-263-1717
Fax Number : 239-403-9410
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2016
Last Update Date : 10/29/2025

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Directions to “ SAMUEL VAZQUEZ-MILAN PA-C” Practice Location

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