Individual
SAMANTHA SYKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13611 NORMANDY BLVD, JACKSONVILLE, FL 32221-2409
(518) 330-7645
Mailing address
13611 NORMANDY BLVD, JACKSONVILLE, FL 32221-2409
(518) 330-7645
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780327635
—
FL
Enumeration date
07/06/2022
Last updated
07/08/2022
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