Marlene Y Samuels, MED-WAIVER PROVIDER

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

4241 SW Hagaplan St
Port St Lucie, FL 34953-6583

Phone

(772) 224-4466

NPI assigned

Nov 21, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Friends Forever, LLC

  • Home Health Agency
  • Port St Lucie, FL
  • NPI 1417316621
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1174037592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4241 SW HAGAPLAN ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349536583",
            "telephone_number": "772-224-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4241 SW HAGAPLAN ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349536583",
            "telephone_number": "772-224-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "MARLENE",
        "middle_name": "Y",
        "credential": "MED-WAIVER PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261QD1600X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC
• Salud Help, LLC
• Sam'S Club Optical
• Stephanie J Sammons, MA, RMHCI
• Sams East Inc
• Maribelle Sanchez Cruz, PHARMD
• Marilyn Sanchez-Raymond
• Keri Sanchez, SLP
• Natalie-Marie Sanchez
• Jillian Tara Sanda, D.C.

• Developmental Disabilities Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.