MEDICARE: SAMANTHA NASTASI

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	207W00000X	Ophthalmology Physician	ME162213	FL

General Provider Information

NPI Number	:	1225597263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA NASTASI

Provider Business Mailing Address
First Line	:	601 S BELCHER RD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33764-6301
Country	:	US
Telephone Number	:	727-266-2393
Fax Number	:	727-266-2330

Provider Business Practice Location Address
First Line	:	601 S BELCHER RD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33764-6301
Country	:	US
Telephone Number	:	727-266-2393
Fax Number	:	727-266-2330

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

Provider Enumeration Date	:	03/19/2019
Last Update Date	:	06/30/2023

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