Phillips-Samuels, Gwendolyn
Phillips-Samuels, Gwendolyn is an sole proprietor health care provider with primary practice located at 1601 Nw 12Th Ave , Miami FL 33136-1005. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Phillips-Samuels, Gwendolyn can be contacted via phone (305) 243-5600.Contact Information
Primary practice address
1601 Nw 12Th Ave
Miami FL 33136-1005
Phone: (305) 243-5600
Fax: (305) 243-4595
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Social Worker | 104100000X | 753154100 | Florida |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist | 222Q00000X | Florida |
Profile Details
NPI number | 1881735355 |
---|---|
LBN Legal business name | Phillips-Samuels, Gwendolyn |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 9th, 2007 |
Last updated | Sep 16th, 2016 - about 8 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1881735355 | NPPES |
Florida | MEDICAID | 753154100 |
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