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NPI Code Detail

MEDICARE: CHANTELL L SAMUELS ARNP

MEDICARE: CHANTELL L SAMUELS ARNP
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
1363LF0000XFamily Nurse PractitionerARNP3343752FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
259-2420282OTHERTAX ID

General Provider Information

NPI Number : 1780990242
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTELL L SAMUELS ARNP
Provider Business Mailing Address
First Line : PO BOX 82969
Second Line :
City : TAMPA
State : FL
Zip : 33682-2969
Country : US
Telephone Number : 813-866-0930
Fax Number : 813-866-0929
Provider Business Practice Location Address
First Line : 4620 N 22 STREET
Second Line :
City : TAMPA
State : FL
Zip : 33610-6205
Country : US
Telephone Number : 813-272-6240
Fax Number : 813-866-0929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2010
Last Update Date : 02/03/2011

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Directions to “ CHANTELL L SAMUELS ARNP” Practice Location

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