Illanez, Samantha

Illanez, Samantha is an individual health care provider with primary practice located at 2135 W State Road 434 , Longwood FL 32779-4983. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Illanez, Samantha can be contacted via phone (407) 789-2673.

Contact Information

Primary practice address
2135 W State Road 434 Longwood FL 32779-4983
Phone: (407) 789-2673
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1073258547
LBN Legal business name Illanez, Samantha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 29th, 2022
Last updated Jul 11th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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