Russell, Samantha L

Russell, Samantha L is an sole proprietor health care provider with primary practice located at 10435 Midtown Pkwy Unit 152, Jacksonville FL 32246-7483. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Russell, Samantha L can be contacted via phone (772) 621-0183.

Contact Information

Primary practice address
10435 Midtown Pkwy Unit 152 Jacksonville FL 32246-7483
Phone: (772) 621-0183
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT15232 Florida

Profile Details

NPI number 1194125567
LBN Legal business name Russell, Samantha L
Credentials MOT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 3rd, 2014
Last updated Sep 3rd, 2014 - about 12 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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