Healthcare Provider Details

I. General information

NPI: 1083543979
Provider Name (Legal Business Name): DR. CARLOS J SAMADA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 SAINT THOMAS AVE
KEY LARGO FL
33037-4321
US

IV. Provider business mailing address

14305 SW 150TH AVE
MIAMI FL
33196-5607
US

V. Phone/Fax

Practice location:
  • Phone: 305-859-1533
  • Fax: 786-904-8859
Mailing address:
  • Phone: 305-859-1533
  • Fax: 786-904-8859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: CARLOS SAMADA
Title or Position: PRESIDENT
Credential: DPM
Phone: 305-859-1533