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NPI Code Detail

MEDICARE: SHARON SAMUELS MS

MEDICARE:   SHARON  SAMUELS  MS
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
1101YM0800XMental Health CounselorIMH11667FL

General Provider Information

NPI Number : 1598185951
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON SAMUELS MS
Provider Business Mailing Address
First Line : 8072 EXCALIBUR CT
Second Line :
City : ORLANDO
State : FL
Zip : 32822-8340
Country : US
Telephone Number : 407-489-7151
Fax Number :
Provider Business Practice Location Address
First Line : 8072 EXCALIBUR CT
Second Line :
City : ORLANDO
State : FL
Zip : 32822-8340
Country : US
Telephone Number : 407-489-7151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2014
Last Update Date : 04/23/2014

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Directions to “ SHARON SAMUELS MS” Practice Location

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