Individual
SAMUEL MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 GULF TO BAY BLVD, CLEARWATER, FL 33759-4514
(813) 574-5200
Mailing address
3400 GULF TO BAY BLVD, CLEARWATER, FL 33759-4514
(813) 574-5200
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA776
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/07/2021
Last updated
03/01/2024
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