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General NPI Number Information
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NPI Number | 1710116454
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Entity Type | Individual
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Provider Name | MICHELINE SAM ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1825 NW 167TH ST STE 108
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-4838
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Country | US
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Telephone | 305-474-1803
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Fax |
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Provider Business Mailing Address
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Address Line | 980 N MICHIGAN AVE STE 1998
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City | CHICAGO
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State | IL
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Zip | 60611-7504
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Country | US
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Telephone | 855-386-2799
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9192688
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License Number State | FL
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