MEDICARE: MRS. DIONNE ANGELA DADD-SAMUELS APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9316487	FL
2	363LA2200X	Adult Health Nurse Practitioner	ARNP9316487	FL

General Provider Information

NPI Number	:	1477823466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIONNE ANGELA DADD-SAMUELS APRN

Provider Business Mailing Address
First Line	:	112 N OAK ST
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33462-3260
Country	:	US
Telephone Number	:	561-565-6837
Fax Number	:	561-828-9310

Provider Business Practice Location Address
First Line	:	112 N OAK ST
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33462-3260
Country	:	US
Telephone Number	:	561-565-6837
Fax Number	:	561-828-9310

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

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	05/18/2026

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