Samoel Antonious
Individual provider Active NPI Pharmacy · Orlando, FL
NPI 1801647334 · NPPES record last updated Apr 1, 2024
Key facts
- NPI
- 1801647334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacy 333600000X
- Practice address
- 2778 Carrickton Cir
Orlando, FL 32824-4230 - Phone
- (407) 639-4806
- NPI assigned
- Apr 1, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes |
Addresses
Primary practice location
2778 Carrickton Cir
Orlando, FL 32824-4230
Mailing address
2778 Carrickton Cir
Orlando, FL 32824-4230
Phone (407) 639-4806
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.