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General NPI Number Information
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NPI Number | 1215178090
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Entity Type | Individual
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Provider Name | SAMANTHA R AVERY D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1615 PASADENA AVE S STE 300
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City | SOUTH PASADENA
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State | FL
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Zip | 33707-4567
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Country | US
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Telephone | 277-490-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 4560 7TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33713-6218
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Country | US
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Telephone | 407-719-3370
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Fax | 917-831-4677
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 34.016407
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS022821
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | DO214145
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01089349A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 73591
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS 11371
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 010143
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License Number State | AZ
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Taxonomy #8
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | DR.0070152
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License Number State | CO
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Taxonomy #9
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 92684
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License Number State | SC
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Taxonomy #10
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 339916
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License Number State | NY
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Taxonomy #11
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MB11818700
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License Number State | NC
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Taxonomy #12
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | DO2023-1051
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License Number State | NM
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Taxonomy #13
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | DO3464
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License Number State | NV
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Taxonomy #14
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MB11818700
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License Number State | NJ
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Taxonomy #15
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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