Sam, Ellen Ann

Sam, Ellen Ann is an sole proprietor health care provider with primary practice located at 21150 Biscayne Blvd Suite 408, Aventura FL 33180-1226. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Sam, Ellen Ann can be contacted via phone (305) 932-3252.

Contact Information

Primary practice address
21150 Biscayne Blvd Suite 408 Aventura FL 33180-1226
Phone: (305) 932-3252
Fax: (305) 932-2798
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X PA9103517 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1740379825
LBN Legal business name Sam, Ellen Ann
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Jun 25th, 2019 - about 5 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 1740379825 NPPES
Florida Other AL007Z MEDICARE
Florida Other AL007Y MEDICARE
Florida MEDICAID 292823000 MEDICARE

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