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NPI Code Detail

MEDICARE: SAMUEL BORRELLI M.D.

MEDICARE: SAMUEL BORRELLI M.D.
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
1207R00000XInternal Medicine PhysicianME133210FL
2207P00000XEmergency Medicine PhysicianME133210FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861805905
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL BORRELLI M.D.
Provider Business Mailing Address
First Line : 1317 EDGEWATER DR # 3767
Second Line :
City : ORLANDO
State : FL
Zip : 32804-6350
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 601 E ROLLINS ST
Second Line :
City : ORLANDO
State : FL
Zip : 32803-1248
Country : US
Telephone Number : 407-303-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2014
Last Update Date : 01/12/2026

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Directions to “ SAMUEL BORRELLI M.D.” Practice Location

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