Provider Demographics
NPI:1255339685
Name:TAPPER, SAMUEL SCOTT (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:SCOTT
Last Name:TAPPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2169 SE OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3305
Mailing Address - Country:US
Mailing Address - Phone:772-286-5501
Mailing Address - Fax:772-781-7767
Practice Address - Street 1:2169 SE OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996
Practice Address - Country:US
Practice Address - Phone:772-286-5501
Practice Address - Fax:772-781-7767
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00634992086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23093YMedicare PIN