Individual
SAMANTHA WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10740 EVENINGWOOD CT, TRINITY, FL 34655-5027
(727) 710-2124
(727) 845-8425
Mailing address
10740 EVENINGWOOD CT, TRINITY, FL 34655-5027
(727) 710-2124
(727) 845-8425
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
230217
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693117100
—
FL
Enumeration date
09/13/2016
Last updated
09/13/2016
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