Healthcare Provider Details

I. General information

NPI: 1265360994
Provider Name (Legal Business Name): SAMANTHA MARIE REIMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE FL
32256-4846
US

IV. Provider business mailing address

10752 DEERWOOD PARK BLVD STE 100
JACKSONVILLE FL
32256-4846
US

V. Phone/Fax

Practice location:
  • Phone: 904-925-6562
  • Fax:
Mailing address:
  • Phone: 904-925-6562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY13202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: