Active NPI
John Samaan
- Pharmacist
- Ponte Vedra, FL
National Provider Identifier
1295104248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS49080
- Practice address
- 120 Marketside Ave
Ponte Vedra, FL 32081-0574 - Phone
- (904) 825-0263
- NPI assigned
- Sep 21, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS49080 | FL | Primary |
Addresses
Primary practice location
120 Marketside Ave
Ponte Vedra, FL 32081-0574
Mailing address
136 Berot Cir
Saint Johns, FL 32259-8024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS49080 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442793600000",
"number": "1295104248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 BEROT CIR",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322598024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 MARKETSIDE AVE",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320810574",
"telephone_number": "904-825-0263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMAAN",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-21",
"last_updated": "2015-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS49080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponte Vedra, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.