Individual
MR. SAMUEL SMITH BLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 W CRYSTAL LAKE ST, SUITE 200, ORLANDO, FL 32806-4475
(407) 254-2500
(407) 423-9512
Mailing address
25 WEST CRYSTAL LAKE STREET, SUITE 200, ORLANDO, FL 32806-9918
(407) 254-2500
(407) 423-9512
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME0062664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3T1121800
—
FL
Enumeration date
01/30/2006
Last updated
01/29/2016
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