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NPI Code Detail

MEDICARE: SAMANTHA CARTER

MEDICARE:   SAMANTHA  CARTER
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
1171M00000XCase Manager/Care CoordinatorFL

General Provider Information

NPI Number : 1891328324
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA CARTER
Provider Business Mailing Address
First Line : 4885 FLORIDA CLUB CIR APT 5311
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-1091
Country : US
Telephone Number : 904-207-1968
Fax Number :
Provider Business Practice Location Address
First Line : 3725 BELFORT RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-5813
Country : US
Telephone Number : 904-296-1055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2020
Last Update Date : 02/10/2026

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