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NPI Code Detail

MEDICARE: GEORGE SAMANIEGO

MEDICARE:   GEORGE  SAMANIEGO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1003491440
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE SAMANIEGO
Provider Business Mailing Address
First Line : 369 BLANDING BLVD STE N23
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-4394
Country : US
Telephone Number : 954-693-6282
Fax Number :
Provider Business Practice Location Address
First Line : 369 BLANDING BLVD STE N23
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-4394
Country : US
Telephone Number : 954-693-6282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2021
Last Update Date : 03/17/2021

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Directions to “ GEORGE SAMANIEGO ” Practice Location

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