Samantha Lynn Diblasi

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

11015265 Issued in FL

Practice address

307 Boatner Rd
Eglin Afb, FL 32542-1302

Phone

(419) 902-4574

NPI assigned

Mar 8, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1184324006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "419-902-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "419-902-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBLASI",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "9366994",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "FL",
            "license": "11015265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Graham Dell, PA-C
• Richard James Delorenzo Jr., M.D., M.P.H.
• Alicia Marie Derkatch
• Alexis Marie Dettrich Felgentrager, DO
• Molly Diamond, MD
• Rebecca Dillon, MD
• Tam T Dinh, PHARMACIST
• Abigail G. Downey, MD
• Jill Dubin, RDH
• William M Dukes, RPH

• Clinical Nurse Specialist in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Clinical Nurse Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.