Dr. Sam, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH9101 Issued in FL

Legal business name

DR. SAM, INC.

Practice address

12651 S Dixie Hwy
Suite 327
Miami, FL 33156-5975

Phone

(786) 299-7548

Fax

(305) 253-3078

NPI assigned

Mar 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Lopez de Victoria, PH.D.

Title

Owner/Director

Phone

(786) 299-7548

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1922424712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12651 S. DIXIE HWY",
            "address_2": "SUITE 327",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565964",
            "telephone_number": "786-299-7548",
            "fax_number": "305-253-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12651 S DIXIE HWY",
            "address_2": "SUITE 327",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565975",
            "telephone_number": "786-299-7548",
            "fax_number": "305-253-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "LOPEZ DE VICTORIA",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "786-299-7548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Miami, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.