# DR. SAMUEL V PELLEGRINO JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447210042
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | ME84614 | FL | — |
| 2086S0127X | Trauma Surgery Physician | ME84614 | FL | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 03/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2707055-00 | — | FL |
| 01 | — | 50172W | HFMG FL MEDICARE | FL |
| 01 | — | 50172X | HFMG FL MEDICARE | FL |
| 01 | — | P01476869 | FL RR MEDICARE | FL |