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NPI Code Detail

MEDICARE: BLESSY JOB SAMUEL APRN

MEDICARE:   BLESSY JOB SAMUEL  APRN
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
1363LA2200XAdult Health Nurse PractitionerAPRN11011128FL

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 : 1861077323
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLESSY JOB SAMUEL APRN
Provider Business Mailing Address
First Line : 9122 BOLECK PL
Second Line :
City : ORLANDO
State : FL
Zip : 32832-7079
Country : US
Telephone Number : 301-221-5736
Fax Number :
Provider Business Practice Location Address
First Line : 9122 BOLECK PL
Second Line :
City : ORLANDO
State : FL
Zip : 32832-7079
Country : US
Telephone Number : 301-221-5736
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2021
Last Update Date : 03/16/2021

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Directions to “ BLESSY JOB SAMUEL APRN” Practice Location

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