Samuel G. Agnew, MD
Individual provider Active NPI Orthopaedic Trauma Physician · Sanford, FL
NPI 1952374498 · NPPES record last updated Jun 4, 2020
Key facts
- NPI
- 1952374498
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Trauma Physician 207XX0801X
- License
- ME102967 (FL)
- Practice address
- 309 N Mangoustine Ave Unit G
Sanford, FL 32771-1098 - Phone
- (321) 363-1754
- Fax
- (321) 363-3336
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME102967 | FL | MD | Orthopaedic Trauma Physician |
| 4301102465 | MI | MD | Orthopaedic Trauma Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pee Dee Orthopedic Assoc | Orthopaedic Surgery | Past | Accepting new patients |
| Florida Hospital Zephyrhills Inc | Past | Accepting new patients | |
| Pee Dee Orthopedic Assoc | Orthopaedic Surgery | Past |
Accepting new patients |
| Florida Hospital Zephyrhills Inc | Past | Accepting new patients | |
| Ocala Health Surgical Group LLC | Orthopaedic Surgery | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 22674 | SC | |
| Orthopaedic Trauma Physician | 207XX0801X | 4301102465 | MI | |
| Orthopaedic Trauma Physician | 207XX0801X | ME102967 | FL | Yes |
Addresses
Primary practice location
309 N Mangoustine Ave Unit G
Sanford, FL 32771-1098
Mailing address
PO Box 370
Fortson, GA 31808-0370
Other providers in Sanford, FL
- Adventist Health System-Sunbelt, Inc
- Adventist Health System/Sunbelt, Inc.
- Adventist Health System/Sunbelt, Inc.
- Liliya Adzhieva
- David Istvan Agamasu
- Carola Cecilia Aguilar Rosales
- Fredrick A Aguilera
- Xavier Aguilera
- Leslie Aguirre
- Rameesha Ahmad
All providers in Sanford, FL · Orthopaedic Trauma Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2020. 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.