Jacob a Samander MD PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME0063339 Issued in FL

Legal business name

JACOB A SAMANDER MD PA

Practice address

1401 SE Goldtree Dr
Ste 104
Port St Lucie, FL 34952-7584

Phone

(772) 905-8531

Fax

(772) 905-8526

NPI assigned

Feb 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jacob A Samander, MD

Title

Owner

Phone

(772) 905-8531

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1356580567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882076",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349882076",
            "telephone_number": "772-905-8531",
            "fax_number": "772-905-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SE GOLDTREE DR",
            "address_2": "STE 104",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527584",
            "telephone_number": "772-905-8531",
            "fax_number": "772-905-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB A SAMANDER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "SAMANDER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-905-8531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0063339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Moore Jackman, OTD, MHS, OTR/L
• Salisa Jackson Garrand, LMHC
• Bridget Lashuwn Jackson, RMHCI
• Chevon Jackson, MSW
• Deja Jackson
• Nadera Jacob, RPH
• Vilna D Jacob
• Brian Bernard Jacobus, DDS, MS, PA
• Nancy Jacques
• Rebecca Jacques, RN

• Psychiatry Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.