Pedro Donosso Sam, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH9658 Issued in FL

Practice address

11440 N Kendall Dr Ste 208
Miami, FL 33176-1024

Phone

(305) 279-5535

Fax

(305) 279-2742

NPI assigned

Oct 14, 2010

Last updated

Jun 17, 2020By 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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Thriveworks Clinical - Florida Inc

  • Mental Health Counselor
  • Fort Lauderdale, FL
  • NPI 1396360996
  Medicare reassignment
• Sun Coast Recovery Ranch LLC

  • Substance Abuse Rehabilitation Facility
  • Southwest Ranches, FL
  • NPI 1508365982
  NPD (past)

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1467762245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH ST STE 409",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615834",
            "telephone_number": "305-891-0050",
            "fax_number": "305-891-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 N KENDALL DR STE 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761024",
            "telephone_number": "305-279-5535",
            "fax_number": "305-279-2742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 E Commercial Blvd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333084029",
            "country_code": "US",
            "telephone_number": "754-400-5514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAM",
        "first_name": "PEDRO",
        "middle_name": "DONOSSO",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George B Salzberg, M.D.
• Sam Medical Center Corp.
• Andy Sam, DO
• Aymara Sam
• Janeth Marie Sam, COTA
• Carlos Lorenzo Sama II, LMT
• Michael Anthony Sama, M.D.
• Karel Samada Fernandez
• Keyla Martha Samada Granda
• Carlos J Samada, DPM

• Mental Health Counselor in Miami, FL
• Providers in Miami, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.