Individual
SAMANTHA SHOSHANA PETRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1601 S ANDREWS AVE FL 3, FORT LAUDERDALE, FL 33316-2509
(954) 763-6655
(954) 763-6799
Mailing address
1608 SE 3RD AVE FL 3, FORT LAUDERDALE, FL 33316-2564
(954) 763-6655
(954) 763-6799
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
11042570
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11042570
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129062900
—
FL
Enumeration date
10/14/2025
Last updated
01/26/2026
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