Individual
CHANTELL L SAMUELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4620 N 22 STREET, TAMPA, FL 33610-6205
(813) 272-6240
(813) 866-0929
Mailing address
PO BOX 82969, TAMPA, FL 33682-2969
(813) 866-0930
(813) 866-0929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP3343752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002634800
—
FL
01
—
59-2420282
TAX ID
—
Enumeration date
08/23/2010
Last updated
02/03/2011
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