Samuels, Marlene Y

Samuels, Marlene Y is an sole proprietor health care provider with primary practice located at 4241 Sw Hagaplan St , Port St Lucie FL 34953-6583. She recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as her primary health care specialty. Samuels, Marlene Y can be contacted via phone (772) 224-4466.

Contact Information

Primary practice address
4241 Sw Hagaplan St Port St Lucie FL 34953-6583
Phone: (772) 224-4466
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X

Profile Details

NPI number 1174037592
LBN Legal business name Samuels, Marlene Y
Credentials MED-WAIVER PROVIDER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2017
Last updated Nov 21st, 2017 - about 9 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 1174037592 NPPES
Florida MEDICAID 261QD1600X

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