Individual
SAMIYA GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(347) 893-3796
Mailing address
37 KENILWORTH PL FL 2, BROOKLYN, NY 11210-2327
(347) 893-3796
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA1046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125592800
—
FL
Enumeration date
01/31/2025
Last updated
02/20/2025
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