Provider Demographics
NPI:1164241196
Name:SAMS, JAUNATHEN
Entity type:Individual
Prefix:
First Name:JAUNATHEN
Middle Name:
Last Name:SAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1897 PALM BEACH LAKES BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3508
Mailing Address - Country:US
Mailing Address - Phone:561-427-5536
Mailing Address - Fax:
Practice Address - Street 1:1897 PALM BEACH LAKES BLVD STE 203
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3508
Practice Address - Country:US
Practice Address - Phone:561-427-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory