Individual provider Active NPI

Samuel Vazquez-Milan, PA-C

  • Surgical Physician Assistant
  • Naples, FL
National Provider Identifier
1255783114
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9112274 Issued in FL
Practice address
801 Anchor Rode Dr Ste 100
Naples, FL 34103-2742
Phone
(239) 263-1717
Fax
(239) 403-9410
NPI assigned
Jul 5, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9112274 FL Primary
Surgical Physician Assistant 363AS0400X 7928 GA
Physician Assistant 363A00000X PA9112274 FL

Addresses

Primary practice location

801 Anchor Rode Dr Ste 100
Naples, FL 34103-2742

Mailing address

801 Anchor Rode Dr Ste 100
Naples, FL 34103-2742
Phone (239) 263-1717

Other practice location 1

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161118001847 GA Practitioner - Physician Assistant 8729367537 Reassigns benefits to 1 organization
I20200203001145 FL Practitioner - Physician Assistant 8729367537 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lisa D Zack MD PAGroup PAC ID 3274629340, 6 clinicians
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

19910 S Tamiami TRL
Suite B
Estero, FL 33928-4140
Phone (239) 263-1717

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

801 Anchor Rode Dr
Suite 100
Naples, FL 34103-2742
Phone (239) 263-1717

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007928GAMDPublic Health Dentist
PA9112274FLMDSurgical Physician Assistant
7928GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Sep 12, 2016 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Mar 23, 2022 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Mar 23, 2022 Accepting new patients
Florida Coastal Surgery Center, Inc PastSince Nov 8, 2025 Accepting new patients
Northwest Florida Multispecialty Physicians LLC PastSince Sep 8, 2021 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1255783114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ANCHOR RODE DR STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341032742",
            "telephone_number": "239-263-1717",
            "fax_number": "239-403-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 ANCHOR RODE DR STE 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341032742",
            "telephone_number": "239-263-1717",
            "fax_number": "239-403-9410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 San Pablo Rd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322241865",
            "country_code": "US",
            "telephone_number": "904-953-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ-MILAN",
        "first_name": "SAMUEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9112274",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "7928",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112274",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.