Provider Demographics
NPI:1982022372
Name:KIRSCHNER, SAMANTHA
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:KIRSCHNER
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 1:2881 SOUTH CAMBRIDGE LANE
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026
Mailing Address - Country:US
Mailing Address - Phone:248-535-6785
Mailing Address - Fax:
Practice Address - Street 1:1290 WESTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1976
Practice Address - Country:US
Practice Address - Phone:954-349-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 16269225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics