Individual provider Active NPI

Samantha Garguilo, PA

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1235599408
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
018927-1 Issued in NY
Practice address
2323 S Orange Ave Ste a
Orlando, FL 32806-3059
Phone
(407) 418-9999
NPI assigned
Mar 2, 2016
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 018927-1 NY Primary

Addresses

Primary practice location

2323 S Orange Ave Ste a
Orlando, FL 32806-3059

Mailing address

14530 S Military TRL
Ste A1-A5
Delray Beach, FL 33484-3706
Phone (561) 381-0260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180706000260 FL Practitioner - Physician Assistant 5193071132 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carespot of Orlando Hsi Urgent Care LLCGroup PAC ID 8921372558, 55 clinicians

Practice addresses (Care Compare)

2323 S Orange Ave a
Carespot Urgent Care
Orlando, FL 32806-3059
Phone (407) 418-9999

311 S Avalon Park Blvd
Orlando, FL 32828-6781
Phone (407) 295-7557

3840 State Rd
436 Suite 1000
Apopka, FL 32703-6041
Phone (615) 600-4074

5355 Red Bug Lake Rd
Winter Springs, FL 32708-4909
Phone (321) 304-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
018927-1NYMDOccupational Therapist

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1235599408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14530 S MILITARY TRL",
            "address_2": "STE A1-A5",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334843706",
            "telephone_number": "561-381-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 S ORANGE AVE STE A",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328063059",
            "telephone_number": "407-418-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARGUILO",
        "first_name": "SAMANTHA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "018927-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.