Provider Demographics
NPI:1245534767
Name:SAMIES, SUSAN A (PA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:SAMIES
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4371 VERONICA S SHOEMAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:1970 GOLF ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-6908
Practice Address - Country:US
Practice Address - Phone:941-957-1000
Practice Address - Fax:941-951-2117
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2014-06-18
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Provider Licenses
StateLicense IDTaxonomies
FLPA2092363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant