Provider Demographics
NPI:1326419623
Name:SHERMAN, SAMANTHA J (PA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:J
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:J
Other - Last Name:GOLDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2611 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4918
Mailing Address - Country:US
Mailing Address - Phone:561-866-7157
Mailing Address - Fax:
Practice Address - Street 1:20665 LYONS RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3911
Practice Address - Country:US
Practice Address - Phone:561-883-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9019069363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical