Provider Demographics
NPI:1770853038
Name:SAMSON, AIDA (PA-C)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:
Last Name:SAMSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AIDA
Other - Middle Name:
Other - Last Name:BAJRAMOVIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:3325 S TAMIAMI TRL STE 200
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5142
Mailing Address - Country:US
Mailing Address - Phone:941-952-9223
Mailing Address - Fax:941-955-0642
Practice Address - Street 1:3325 S TAMIAMI TRL STE 200
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5142
Practice Address - Country:US
Practice Address - Phone:941-952-9223
Practice Address - Fax:941-955-0642
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106276363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical