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Individual

SAMUEL FITZSIMONS RAVENEL II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6671 CAROLINE ST, MILTON, FL 32570-4781
(850) 981-9433
(850) 981-9436
Mailing address
2315 W JACKSON ST, PENSACOLA, FL 32505-7552
(850) 436-4630
(850) 436-2095

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME128058
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017919600
FL
01
KD915
MCR FL
FL
01
M8P04
BCBS FL
FL
Enumeration date
05/24/2006
Last updated
04/07/2026
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