MEDICARE: SAMANTHA ABBOTT 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	363LF0000X	Family Nurse Practitioner	APRN11017388	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558012013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ABBOTT APRN

Provider Business Mailing Address
First Line	:	2068 HEALTH CARE AVE
Second Line	:
City	:	NAVARRE
State	:	FL
Zip	:	32566-2901
Country	:	US
Telephone Number	:	850-939-1200
Fax Number	:	850-916-8001

Provider Business Practice Location Address
First Line	:	2068 HEALTH CARE AVE
Second Line	:
City	:	NAVARRE
State	:	FL
Zip	:	32566-2901
Country	:	US
Telephone Number	:	850-939-1200
Fax Number	:	850-983-8001

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

Provider Enumeration Date	:	01/15/2022
Last Update Date	:	11/11/2025

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