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General NPI Number Information
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NPI Number | 1902216476
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Entity Type | Individual
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Provider Name | SAMANTHA RAO DISPARTI PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 18135 ATHERSTONE TRL
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City | LAND O LAKES
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State | FL
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Zip | 34638-8158
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Country | US
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Telephone | 727-359-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 11061 BREMERTON CT
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City | NEW PORT RICHEY
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State | FL
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Zip | 34654-4698
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT15128
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | FL
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