Healthcare Provider Details

I. General information

NPI: 1750213229
Provider Name (Legal Business Name): SAMUEL WU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20825 CEDAR BLUFF PL
LAND O LAKES FL
34638-3714
US

IV. Provider business mailing address

20825 CEDAR BLUFF PL
LAND O LAKES FL
34638-3714
US

V. Phone/Fax

Practice location:
  • Phone: 813-993-6098
  • Fax:
Mailing address:
  • Phone: 813-993-6098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: