Healthcare Provider Details

I. General information

NPI: 1639099674
Provider Name (Legal Business Name): SAMARA JULES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 LAKE HOWELL RD FL 32751
MAITLAND FL
32751-5900
US

IV. Provider business mailing address

2904 XAVIER CT
ORLANDO FL
32826-3426
US

V. Phone/Fax

Practice location:
  • Phone: 407-637-2633
  • Fax: 407-558-3438
Mailing address:
  • Phone: 407-788-7851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: