Healthcare Provider Details

I. General information

NPI: 1457238750
Provider Name (Legal Business Name): SAMANTHA PASTIR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1986 31ST AVE STE 100
VERO BEACH FL
32960-6627
US

IV. Provider business mailing address

2328 CROWNED EAGLE CIR SW
VERO BEACH FL
32962-6843
US

V. Phone/Fax

Practice location:
  • Phone: 772-257-5390
  • Fax:
Mailing address:
  • Phone: 772-532-8563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11045488
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: