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Individual

SAMANTHA TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
1550 E VENICE AVE, VENICE, FL 34292-1661
(941) 792-2020
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-8575
(864) 359-1308
(239) 496-3939

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC6525
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPC6525
FLORIDA BOARD OF OPTOMETRY
FL
Enumeration date
07/10/2024
Last updated
04/30/2026
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