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General NPI Number Information
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NPI Number | 1770410508
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Entity Type | Individual
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Provider Name | SAMANTHA AXELROD
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Gender | Female
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 11621 KEW GARDENS AVE STE 101A
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2853
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Country | US
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Telephone | 954-665-8090
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Fax | 561-232-3074
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Provider Business Mailing Address
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Address Line | 6047 UNGERER ST
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City | JUPITER
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State | FL
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Zip | 33458-6607
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Country | US
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Telephone | 954-665-8090
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Fax | 561-232-3074
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS62335
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License Number State | FL
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