Individual
SAMANTHA RAZAVI HANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3627 UNIVERSITY BLVD S, SUITE 700, JACKSONVILLE, FL 32216-4230
(904) 399-5678
(904) 399-8488
Mailing address
3627 UNIVERSITY BLVD S, SUITE 700, JACKSONVILLE, FL 32216-4230
(904) 399-5678
(904) 399-8488
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
COA-12326-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015482700
—
FL
Enumeration date
05/03/2011
Last updated
02/09/2022
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