Provider Demographics
NPI:1982080933
Name:SAMANTHA S. LINDSAY M.D. P.A.
Entity type:Organization
Organization Name:SAMANTHA S. LINDSAY M.D. P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-518-4548
Mailing Address - Street 1:1029 SWEET JASMINE DR
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-7136
Mailing Address - Country:US
Mailing Address - Phone:727-518-0647
Mailing Address - Fax:
Practice Address - Street 1:16541 POINTE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5258
Practice Address - Country:US
Practice Address - Phone:813-920-8300
Practice Address - Fax:813-920-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002813600Medicaid
FL002813600Medicaid