Samantha Nycole Fridman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9117373 Issued in FL

Practice address

5451 N University Dr Ste 103
Coral Springs, FL 33067-4641

Phone

(954) 242-4275

NPI assigned

May 10, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Nycole Schultz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1841980133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 POINCIANA DR",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331604522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 N UNIVERSITY DR STE 103",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674641",
            "telephone_number": "954-242-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDMAN",
        "first_name": "SAMANTHA",
        "middle_name": "NYCOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SCHULTZ",
            "middle_name": "NYCOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.