Healthcare Provider Details

I. General information

NPI: 1740923119
Provider Name (Legal Business Name): SAMANTHA NICHOLE SHERKIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 S COMPASS WAY
DANIA FL
33004-2368
US

IV. Provider business mailing address

800 MEADOWS RD
BOCA RATON FL
33486-2304
US

V. Phone/Fax

Practice location:
  • Phone: 954-807-9433
  • Fax: 561-955-3577
Mailing address:
  • Phone: 561-955-5365
  • Fax: 561-955-3577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: