Healthcare Provider Details

I. General information

NPI: 1215871009
Provider Name (Legal Business Name): SAMANTHA TOUZE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4620 N 22ND ST
TAMPA FL
33610-6205
US

IV. Provider business mailing address

4620 N 22ND ST
TAMPA FL
33610-6205
US

V. Phone/Fax

Practice location:
  • Phone: 813-397-5300
  • Fax: 813-738-9034
Mailing address:
  • Phone: 813-397-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11046714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: