Provider Demographics
NPI:1417640392
Name:SAMPEUR, JOSEPH IRESMICK VII
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:IRESMICK
Last Name:SAMPEUR
Suffix:VII
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 SW 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-2723
Mailing Address - Country:US
Mailing Address - Phone:786-735-7511
Mailing Address - Fax:
Practice Address - Street 1:1272 NW 119TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-3232
Practice Address - Country:US
Practice Address - Phone:305-685-5688
Practice Address - Fax:888-816-0924
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22-317246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty