MEDICARE: SAMANTHA LONGO

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	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1982239166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA LONGO

Provider Business Mailing Address
First Line	:	1055 E TROPICANA AVE UNIT 253C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 E TROPICANA AVE UNIT 253C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6616
Country	:	US
Telephone Number	:	520-262-2012
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2020
Last Update Date	:	03/07/2020

Similar Medicare Providers

1861635302 — A PLUS A MEDICAL SUPPLIES, LLC
Practice Location Address:

1055 E. TROPICANA AVE. , SUITE #130
LAS VEGAS, NV
89119-6616

Practice Phone: 702-262-2252
Practice Fax:

1750194882 — AALIYAH HAYNES RN
Practice Location Address:

1055 E TROPICANA AVE UNIT 310D
LAS VEGAS, NV
89119-6616

Practice Phone: 443-226-1199
Practice Fax:

1245561562 — ANNETTE LOVE
Practice Location Address:

7500 W. LAKE MEAD BLVD
LAS VEGAS, NV
89128-6616

Practice Phone: 702-587-3196
Practice Fax:

1962704189 — MR. THEODIS THROWER JR.
Practice Location Address:

6616 NIGHT OWL BLUFF AVE
NORTH LAS VEGAS, NV
89084-2027

Practice Phone: 702-764-0613
Practice Fax:

1487956462 — MR. STEPHONE REVELS
Practice Location Address:

5316 SUMMER TROUT ST
N LAS VEGAS, NV
89031-6616

Practice Phone: 702-296-9458
Practice Fax:

1497028401 — CORNELL WILLIAMS
Practice Location Address:

6616 LAVENDER LILLY LN #1
N. LAS VEGAS, NV
89084

Practice Phone: 702-917-5101
Practice Fax:

Directions to “ SAMANTHA LONGO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.