Phillips-Samuels, Gwendolyn

Phillips-Samuels, Gwendolyn is an sole proprietor health care provider with primary practice located at 1601 Nw 12Th Ave , Miami FL 33136-1005. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Phillips-Samuels, Gwendolyn can be contacted via phone (305) 243-5600.

Contact Information

Primary practice address
1601 Nw 12Th Ave Miami FL 33136-1005
Phone: (305) 243-5600
Fax: (305) 243-4595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 753154100 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X Florida

Profile Details

NPI number 1881735355
LBN Legal business name Phillips-Samuels, Gwendolyn
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2007
Last updated Sep 16th, 2016 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1881735355 NPPES
Florida MEDICAID 753154100

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