Dejesus, Samuel

Dejesus, Samuel is an individual health care provider with primary practice located at 32 W Gore St Ste 204 , Orlando FL 32806-1134. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Dejesus, Samuel can be contacted via phone (407) 649-6884.

Contact Information

Primary practice address
32 W Gore St Ste 204 Orlando FL 32806-1134
Phone: (407) 649-6884
Fax: (407) 245-7059
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X ME78134 Florida

Profile Details

NPI number 1497757645
LBN Legal business name Dejesus, Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Aug 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497757645 NPPES
Florida MEDICAID 259597400

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