Provider Demographics
NPI:1184067704
Name:SALTZ, SAMANTHA BLOCK (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:BLOCK
Last Name:SALTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:GAYLE
Other - Last Name:BLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2600 N MILITARY TRL STE 355
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6330
Mailing Address - Country:US
Mailing Address - Phone:561-510-9150
Mailing Address - Fax:561-600-9655
Practice Address - Street 1:2600 N MILITARY TRL STE 355
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6330
Practice Address - Country:US
Practice Address - Phone:561-510-9150
Practice Address - Fax:561-600-9655
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1316982084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry