Healthcare Provider Details

I. General information

NPI: 1124745898
Provider Name (Legal Business Name): SAMANTHA JANVIER FELIX PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA JANVIER

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14311 BISCAYNE BLVD UNIT 613152
NORTH MIAMI FL
33181-1205
US

IV. Provider business mailing address

14311 BISCAYNE BLVD UNIT 613152
NORTH MIAMI FL
33181-1205
US

V. Phone/Fax

Practice location:
  • Phone: 786-520-6926
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2022035602
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: