Healthcare Provider Details

I. General information

NPI: 1578244414
Provider Name (Legal Business Name): SAMANTHA HUFFMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 09/26/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 GLADES RD STE 100
BOCA RATON FL
33431-6466
US

IV. Provider business mailing address

1398 NW 14TH CT
BOCA RATON FL
33486-3234
US

V. Phone/Fax

Practice location:
  • Phone: 561-395-9200
  • Fax:
Mailing address:
  • Phone: 561-843-8175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11027601
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: