Scott B. Samera, DPM, PA, LLC

Organization Active NPI Foot & Ankle Surgery Podiatrist · Branford, FL

NPI 1043591936 · NPPES record last updated Feb 4, 2013

Key facts

NPI
1043591936
Entity type
Organization (NPI type 2)
Primary specialty
Foot & Ankle Surgery Podiatrist 213ES0103X
License
PO3510 (FL)
Legal business name
SCOTT B. SAMERA, DPM, PA, LLC
Practice address
303 Suwannee Ave NW
Branford, FL 32008-3275
Phone
(386) 935-1093
NPI assigned
Sep 6, 2011
Organization subpart
No

Authorized official

Name
Dr. Scott Samera, DPM
Title
Podiatrist
Phone
(386) 935-1093

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20111021000466 FL Part B Supplier - Clinic/Group Practice 1850564659 Receives reassigned benefits from 1 practitioner
Practice locations: Lake City, FL; Branford, FL

National Provider Directory

Locations

404 NW Hall of Fame Dr
#2
Lake City, FL 32055

404 NW Hall of Fame Dr
Fl 2
Lake City, FL 32055

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213ES0103X PO3510 FL Yes

Addresses

Primary practice location

303 Suwannee Ave NW
Branford, FL 32008-3275

Mailing address

PO Box 846
Branford, FL 32008-0846
Phone (386) 935-1093

Other providers in Branford, FL

All providers in Branford, FL · Foot & Ankle Surgery Podiatrist in Florida

Sources for this page

Verify at the official NPI Registry.