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General NPI Number Information
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NPI Number | 1306864590
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Entity Type | Individual
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Provider Name | JOSEPH ERICK SAMUELS D.O.M.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 2639 W NORVELL BRYANT HWY
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City | LECANTO
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State | FL
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Zip | 34461-9440
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Country | US
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Telephone | 352-746-5669
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Fax | 352-746-5795
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Provider Business Mailing Address
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Address Line | 2639 W NORVELL BRYANT HWY
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City | LECANTO
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State | FL
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Zip | 34461-9440
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Country | US
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Telephone | 352-746-5669
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Fax | 352-746-5795
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 1286
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License Number State | FL
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