Marie Samantha Florestal, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11000144 Issued in FL

Practice address

2601 Wells Ave Ste 141
Fern Park, FL 32730-2000

Phone

(407) 335-4050

Fax

(888) 595-5746

NPI assigned

Apr 4, 2019

Last updated

Aug 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Complete Health and Wellness Clinic, LLC

  • Family Medicine Physician
  • Fern Park, FL
  • NPI 1124852546
  NPD Authorized official
• Shawnee Mission Medical Center Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Merriam, KS
  • NPI 1992735690
  NPD (past)

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725062400000",
    "number": "1316409642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 WELLS AVE STE 141",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "327302000",
            "telephone_number": "407-335-4050",
            "fax_number": "888-595-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 WELLS AVE STE 141",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "327302000",
            "telephone_number": "407-335-4050",
            "fax_number": "888-595-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORESTAL",
        "first_name": "MARIE",
        "middle_name": "SAMANTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-08-31",
        "certification_date": "2024-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estapona Operating, LLC (Strive at Fern Park)
• Eye Express, Inc
• Fern Park Dental Corp
• Zachariah Fikru
• Mearlene Filkins, MSW
• Candace Fouquet, LMFT, LMHC
• Rocky A Francis, RPH
• Christie Garcia, RN
• Karla Gonzalez, ATC, LAT
• Danielle McCarty Gorman

• Family Nurse Practitioner in Fern Park, FL
• Providers in Fern Park, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2024; 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.