Bryant Cornelius Samuels II

Primary specialty

TechnicianTaxonomy code 374700000X

Practice address

4203 SW High Meadows Ave
Palm City, FL 34990-3726

Phone

(772) 222-5560

NPI assigned

Oct 3, 2022

Last updated

Oct 3, 2022By the provider in NPPES

Sex

Male

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)

Not enrolled

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.

• Treasure Coast ABA Services

  • Behavior Technician
  • Palm City, FL
  • NPI 1316669732
  NPD

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1356065213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 SW HAMMOCK CREEK DR",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349907930",
            "telephone_number": "315-406-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 SW HIGH MEADOWS AVE",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349903726",
            "telephone_number": "772-222-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "BRYANT",
        "middle_name": "CORNELIUS",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Russell
• Kristin Ryan, RN
• Makayla Sadecky, RBT
• Sarah Sadow
• Christopher Vincent Salomoni, PT
• Carol San Antonio, APRN
• Yaumara Sanchez, RBT
• Taylor Sanders
• Steven John Sanderson, ARNP
• Sandhill Cove LLC (Water's Edge Health and Rehabilitation)

• Technician in Palm City, FL
• Providers in Palm City, FL by specialty
• Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.