Samdazie LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SAMDAZIE LLC

Doing business as

PRESTIGE MOBILE WOUND CONSULTANTS

Practice address

331 NW 27TH Ave
Fort Lauderdale, FL 33311-8632

Phone

(954) 496-2599

NPI assigned

Mar 10, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Henry OdazieNPI 1740880848

Title

Medical Director

Phone

(954) 440-0983

Specialties & licenses 1

Addresses

Other names 1

• PRESTIGE MOBILE WOUND CONSULTANTS Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Henry Odazie, FNP-C

  • Family Nurse Practitioner
  • Oakland Park, FL
  • NPI 1740880848
  Medicare reassignment NPD Authorized official
• Mark Gordon

  • Family Nurse Practitioner
  • Lauderhill, FL
  • NPI 1497183404
  Medicare reassignment NPD
• Chinedu Obinna Okeke, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Tampa, FL
  • NPI 1942663364
  Medicare reassignment NPD

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1396493201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NW 27TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333118632",
            "telephone_number": "954-496-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 NW 27TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333118632",
            "telephone_number": "954-496-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMDAZIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "ODAZIE",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-440-0983",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drhenry@prestigeclinicians.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf",
            "address_1": "331 NW 27th Ave",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333118632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PRESTIGE MOBILE WOUND CONSULTANTS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRESTIGE MOBILE WOUND CONSULTANTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon Saluk
• Damon R Salzman, MD
• Sam J Sugar MD Facp
• Samantha Samaan
• Samaritan Counseling Center
• Samer Elhakim MD PA
• Sindi Kay Samis
• Miranda W Sampath
• Monica Samper, LMHC
• Marianne Sampson, OT

• Clinic/Center in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.