Healthcare Provider Details

I. General information

NPI: 1255339685
Provider Name (Legal Business Name): SAMUEL SCOTT TAPPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2169 SE OCEAN BLVD
STUART FL
34996
US

IV. Provider business mailing address

2169 SE OCEAN BLVD
STUART FL
34996-3305
US

V. Phone/Fax

Practice location:
  • Phone: 772-286-5501
  • Fax: 772-781-7767
Mailing address:
  • Phone: 772-286-5501
  • Fax: 772-781-7767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME0063499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: