Provider Demographics
NPI:1003630252
Name:ALFIAN, SAMANTHA S (APRN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:S
Last Name:ALFIAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 SW 135TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3308
Mailing Address - Country:US
Mailing Address - Phone:786-897-5295
Mailing Address - Fax:
Practice Address - Street 1:1450 NW 87TH AVE STE 206-207
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-3004
Practice Address - Country:US
Practice Address - Phone:305-988-8528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine