Provider Demographics
NPI:1710584875
Name:ZEMAN, SAMANTHA (LPTA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:ZEMAN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 MOUNT HOMER RD APT 72
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-6267
Mailing Address - Country:US
Mailing Address - Phone:407-844-8933
Mailing Address - Fax:
Practice Address - Street 1:2884 WELLNESS AVE STE 300
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8427
Practice Address - Country:US
Practice Address - Phone:386-774-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA30234208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation