MEDICARE: GREGORY P SAMANO II DO

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
1	207Q00000X	Family Medicine Physician	057764	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	47244	OTHER	FL	BC BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205804226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY P SAMANO II DO

Provider Business Mailing Address
First Line	:	499 E CENTRAL PKWY
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3449
Country	:	US
Telephone Number	:	407-543-3461
Fax Number	:	407-678-0627

Provider Business Practice Location Address
First Line	:	499 E CENTRAL PKWY
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-3449
Country	:	US
Telephone Number	:	407-543-3461
Fax Number	:	407-678-0627

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	02/11/2020

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Directions to “ GREGORY P SAMANO II DO” Practice Location

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