Healthcare Provider Details

I. General information

NPI: 1114848314
Provider Name (Legal Business Name): SAMANTHA SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 152ND ST STE 103
PALMETTO BAY FL
33157-2066
US

IV. Provider business mailing address

8950 SW 152ND ST STE 103
PALMETTO BAY FL
33157-2066
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-3840
  • Fax:
Mailing address:
  • Phone: 786-596-3840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN9652019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: