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Individual

DAVID J SAMARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6555 CHESTER AVE STE 1, JACKSONVILLE, FL 32217-2279
(904) 309-6504
(904) 503-3577
Mailing address
6555 CHESTER AVE STE 1, JACKSONVILLE, FL 32217-2279
(904) 309-6504
(904) 503-3577

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
ME31637
FL
208D00000X
General Practice Physician
ME31637
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
059539000
FL
01
15431
BLUE SHIELD
FL
01
340017155
RAILROAD MEDICARE
01
ME31637
MEDICAL LIC
FL
Enumeration date
06/08/2006
Last updated
03/08/2016
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