Provider Demographics
NPI:1013437466
Name:SAMUELS, ANDREW DONALD (TT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DONALD
Last Name:SAMUELS
Suffix:
Gender:M
Credentials:TT
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:
Other - Last Name:SAMUELS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRT
Mailing Address - Street 1:3155 HOLIDAY SPRINGS BLVD APT 8
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5459
Mailing Address - Country:US
Mailing Address - Phone:954-376-1377
Mailing Address - Fax:
Practice Address - Street 1:3155 HOLIDAY SPRINGS BLVD APT 8
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5459
Practice Address - Country:US
Practice Address - Phone:954-376-1377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT8704227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified