Provider Demographics
NPI:1588117220
Name:SAMA, ANTONIO ALFREDO
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:ALFREDO
Last Name:SAMA
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 1:13470 SW 78TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3304
Mailing Address - Country:US
Mailing Address - Phone:305-773-5057
Mailing Address - Fax:
Practice Address - Street 1:2150 TOWN SQUARE PL STE 290
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1643
Practice Address - Country:US
Practice Address - Phone:281-768-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic