Provider Demographics
NPI:1487216347
Name:SAMAROO, DIONNE
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:
Last Name:SAMAROO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12373 HAGAN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8319
Mailing Address - Country:US
Mailing Address - Phone:904-704-3901
Mailing Address - Fax:904-467-8994
Practice Address - Street 1:12373 HAGAN CREEK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8319
Practice Address - Country:US
Practice Address - Phone:904-704-3901
Practice Address - Fax:904-467-8994
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care