Illanez, Samantha
Illanez, Samantha is an individual health care provider with primary practice located at 2135 W State Road 434 , Longwood FL 32779-4983. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Illanez, Samantha can be contacted via phone (407) 789-2673.Contact Information
Primary practice address
2135 W State Road 434
Longwood FL 32779-4983
Phone: (407) 789-2673
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
NPI number | 1073258547 |
---|---|
LBN Legal business name | Illanez, Samantha |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 29th, 2022 |
Last updated | Jul 11th, 2023 - about last year |
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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