MEDICARE: DAVID J SAMUELS MD PA

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
1	207L00000X	Anesthesiology Physician	ME54705	FL

General Provider Information

NPI Number	:	1881600690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID J SAMUELS MD PA

Provider Business Mailing Address
First Line	:	5121 W SAN JOSE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6414
Country	:	US
Telephone Number	:	813-833-7937
Fax Number	:

Provider Business Practice Location Address
First Line	:	5121 W SAN JOSE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6414
Country	:	US
Telephone Number	:	813-833-7937
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID SAMUELS
Credential	:
Telephone Number	:	813-833-7937

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	08/22/2020

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