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General NPI Number Information
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NPI Number | 1285538769
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Entity Type | Individual
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Provider Name | SAMUEL SANTOS PAULON I PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 3402 N ANDREWS AVENUE EXT
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City | POMPANO BEACH
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State | FL
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Zip | 33064-2067
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Country | US
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Telephone | 954-368-1302
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 NE 8TH TER
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City | POMPANO BEACH
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State | FL
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Zip | 33064-6411
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Country | US
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Telephone | 954-902-8260
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3278
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TPPA1391
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License Number State | FL
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