Organization
ACCOUNTABLESELF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONI SAMUEL NP (DIRECTOR)
(407) 757-4459
Entity
Organization
Contact information
Practice address
13750 W COLONIAL DR STE 350-111, WINTER GARDEN, FL 34787-4204
(407) 757-4459
Mailing address
14146 JOMATT LOOP, WINTER GARDEN, FL 34787-0116
(407) 757-4459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
251E00000X
Home Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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