MRS. ELLEN ANN SAM (NPI# 1740379825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740379825 |
| Entity Type | Individual |
| Full Name | MRS. ELLEN ANN SAM |
| Credential | PA |
| Practice Address |
21150 Biscayne Blvd Suite 408 Aventura FL 33180-1226 |
| Mailing Address |
11880 Sw 40th St Suite 304 Miami FL 33175-3584 |
| Practice Telephone | 3059323252 |
| Practice Fax Number | 3059322798 |
| Mailing Telephone | 3052238808 |
| Mailing Fax Number | 3052238974 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2019-06-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | PA9103517 | FL | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 292823000 | 05 | |
| FL | MEDICARE | AL007Z | 01 |
| FL | MEDICARE | AL007Y | 01 |
| Street Address |
21150 BISCAYNE BLVD SUITE 408 |
| City | AVENTURA |
| State | FL |
| Zip Code | 33180-1226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596098 | Marvin Diaz-lacayo | Specialist | 21150 Biscayne Blvd, Ste 101, Aventura, FL 33180-1226 | 2005-05-23 |
| 1639621972 | Joanna Dinan | Nurse Practitioner | 21150 Biscayne Blvd, Aventura, FL 33180 | 2016-11-03 |
| 1881053304 | Denise Frances Rivera | Nurse Practitioner | 21150 Biscayne Blvd, Aventura, FL 33180-1226 | 2016-02-11 |
| 1801253695 | Spine Specialists of South Florida LLC | Durable Medical Equipment & Medical Supplies | 21150 Biscayne Blvd, Ste 101, Aventura, FL 33180-1226 | 2016-01-25 |
| 1821476896 | Urocare-all LLC | Specialist | 21150 Biscayne Blvd, Suite 404, Aventura, FL 33180-1226 | 2015-05-11 |
| 1265861504 | Margaret Mcknight | Physician Assistant | 21150 Biscayne Blvd, Suite 400, Aventura, FL 33180-1226 | 2013-11-07 |
| 1538405857 | Ivette Cardelli | Nurse Practitioner | 21150 Biscayne Blvd, Suite 106, Aventura, FL 33180-1226 | 2012-12-13 |
| 1891074746 | Dina Rachel Edrich | Family Medicine | 21150 Biscayne Blvd, Suite 302, Aventura, FL 33180-1226 | 2011-08-10 |
| 1588953681 | Hj Richman Dds, Pa | Dentist | 21150 Biscayne Blvd, Suite 401, Aventura, FL 33180-1226 | 2011-03-30 |
| 1497054332 | Carlista Jones | Licensed Practical Nurse | 21150 Biscayne Blvd, Suite 400, Aventura, FL 33180-1226 | 2011-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607849 | Nabeel Rahman Khan | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Boulevard, Avetura, Fl, Aventura, FL 33180 | 2020-04-09 |
| 1235766841 | Hanny Hausmann | Counselor | 2999 Ne 191 Street, Suite 902, Aventura, FL 33180 | 2020-03-24 |
| 1760976369 | Michael Ernest Molino | Optometrist | 19575 Biscayne Blvd Ste 579, Aventura, FL 33180 | 2018-06-18 |
| 1932602620 | Carmen Somarriba | Physician Assistant | 21110 Biscayne Blvd Bldg Suite400, Aventura, FL 33180 | 2018-03-09 |
| 1235631474 | Premier Florida Podiatry, Pa | Podiatrist | 3060 Ne 190th St Apt 202, Aventura, FL 33180 | 2018-03-04 |
| 1891229126 | Ifrah Zahid Butt | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd., Aventura, FL 33180 | 2017-04-13 |
| 1629500129 | Hector Hugo Gonzalez | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd, South Tower, #807, Aventura Hospital and Medical Center, Aventura, FL 33180 | 2017-04-03 |
| 1457892671 | Nusen Beer | Internal Medicine | 20200 W Dixie Hwy Ste 701, Aventura, FL 33180 | 2017-03-20 |
| 1073052338 | Alfa Diagnostic LLC | Point of Service | 21355 E Dixie Hwy Ste 101, Aventura, FL 33180 | 2017-02-20 |
| 1598211740 | Katherine Mendez-martinez | Nurse Practitioner | 2925 Aventura Blvd. Suite 101, Aventura, FL 33180 | 2016-08-28 |
| Find all providers in zip 33180 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045056 | Nicole Sultan | Physician Assistant | 20281 E Country Club Dr Apt 1903, Aventura, FL 33180-3032 | 2019-04-04 |
| 1487112181 | Jose A Idone | Physician Assistant | 21378 Marina Cove Cir Apt B19, Aventura, FL 33180-3562 | 2019-03-12 |
| 1932602620 | Carmen Somarriba | Physician Assistant | 21110 Biscayne Blvd Bldg Suite400, Aventura, FL 33180 | 2018-03-09 |
| 1285145896 | Jason Mark Mcpherson | Physician Assistant | 19406 E Country Club Dr, Aventura, FL 33180-4823 | 2017-10-23 |
| 1093188617 | Diana Soare | Physician Assistant | 17880 Ne 31st Ct, Aventura, FL 33160-5018 | 2015-11-04 |
| 1902279888 | Galaxy Emergency Physicians, LLC | Physician Assistant | 20800 Biscayne Blvd, Aventura, FL 33180-1443 | 2015-11-02 |
| 1184878381 | Christopher Maurice Rosenbarger | Physician Assistant | 3619 Ne 207th St, Apt. 2310, Aventura, FL 33180-4705 | 2008-11-14 |
| 1205908068 | Rashida Natacha Joemmankhan | Physician Assistant | 21110 Biscayne Blvd Ste 308, Aventura, FL 33180-1229 | 2006-11-15 |
| 1184717811 | Sherry Roth | Physician Assistant | 20533 Biscayne Blvd, Suite 1337, Aventura, FL 33180-1529 | 2006-10-02 |
| 1922082148 | Rachel E Krackov | Physician Assistant | 15400 Biscayne Blvd, Suite 103, Aventura, FL 33160-4614 | 2005-12-01 |
| Find all providers in AVENTURA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.