Provider Demographics
NPI:1982992061
Name:MEYERS, SAMANTHA JUSTICE
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JUSTICE
Last Name:MEYERS
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 1:2259 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1106
Mailing Address - Country:US
Mailing Address - Phone:954-725-4160
Mailing Address - Fax:954-725-4170
Practice Address - Street 1:3500 CLUBHOUSE LN
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-6002
Practice Address - Country:US
Practice Address - Phone:561-735-8559
Practice Address - Fax:561-536-5852
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26606225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist