Provider Demographics
NPI:1437590320
Name:SAMAAN, MENA MICHAEL DANIAL (MD)
Entity Type:Individual
Prefix:DR
First Name:MENA
Middle Name:MICHAEL DANIAL
Last Name:SAMAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 KINDERKAMACK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1600
Mailing Address - Country:US
Mailing Address - Phone:201-342-2550
Mailing Address - Fax:
Practice Address - Street 1:1401 CENTERVILLE RD STE 300
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4675
Practice Address - Country:US
Practice Address - Phone:850-877-5115
Practice Address - Fax:850-656-3645
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1642582084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology