IVAN SAMCAM (NPI# 1194131730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194131730 |
| Entity Type | Individual |
| Full Name | IVAN SAMCAM |
| Credential | M.D. |
| Practice Address |
6640 78th Ave N Ste A Pinellas Park FL 33781 |
| Mailing Address |
1600 Sw Archer Rd #100186 Gainesville FL 32610-3001 |
| Practice Telephone | 7275188662 |
| Practice Fax Number | 7275188662 |
| Mailing Telephone | 3522655911 |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2018-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | ME131378 | FL | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
ME131378 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE PTAN | JA096Z | 01 |
| FL | 021231300 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1414 Kuhl Ave # Mp31, Orlando, FL 328062008 | 4072376329 | 4076493083 |
| Street Address |
6640 78TH AVE N STE A |
| City | PINELLAS PARK |
| State | FL |
| Zip Code | 33781 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215554134 | Tanthia Chanel Delgado | Social Worker | Sequel Care of Florida, 3491 Gandy Blvd, Pinellas Park, FL 33781 | 2020-06-26 |
| 1932722139 | Sunrise Retirement Home LLC | Assisted Living Facility | 4201 70th Ave North, Pinellas Park, FL 33781 | 2020-05-21 |
| 1790319119 | Third Phase Medical, LLC Dba Physical Therapy Now, Pinellas Park | Physical Medicine & Rehabilitation | 6661 49th Street North, Pinellas Park, FL 33781 | 2020-02-25 |
| 1275166621 | Michael Palon | Chiropractor | 6615 49th St N, Pinellas Park, FL 33781 | 2020-02-13 |
| 1679080790 | Hyde Psychological Services LLC | Psychologist | 8130 66th St. N, Suite 10, Pinellas Park, FL 33781 | 2018-01-10 |
| 1184135964 | Susan Nmi Washam | Counselor | 3491 Gandy Blvd, Suite 201, Pinelias Park, FL 33781 | 2017-10-19 |
| 1306278809 | Select Medical Products | Durable Medical Equipment & Medical Supplies | 6531 47th Street North, Pinellas Park, FL 33781 | 2013-08-07 |
| 1639515133 | Kabrena Michelle Williams | Behavioral Analyst | 5030 78th Ave N Ste 11, Pinellas Park, FL 33781 | 2013-05-11 |
| 1649614975 | Dennis Alexander Tenenboym | Podiatrist | 7800 66th St N Ste 207, Pinellas Park, FL 33781 | 2013-04-17 |
| 1174868962 | Nurses Helping Hands | Assisted Living Facility | 7191 71st St. N., Pinellas Park, FL 33781 | 2012-12-05 |
| Find all providers in zip 33781 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598720849 | Charles Kim Friedman | Pain Medicine | 6640 78th Ave N, Ste A, Pinellas Park, FL 33781 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979706 | Specialty Physician Services. LLC | Pain Medicine | 9150 Sw 87th Ave Ste 200, Miami, FL 33176-2313 | 2020-10-12 |
| 1700403847 | Advanced Interventional Pain Center Fl | Pain Medicine | 1831 N Belcher Rd Ste E1, Clearwater, FL 33765-1442 | 2020-07-05 |
| 1770108110 | The Neomedicine Institute LLC | Pain Medicine | 2510 Nw 97th Ave Ste 110, Doral, FL 33172-1407 | 2020-06-11 |
| 1316583362 | Lisa M Gonzalez | Pain Medicine | 8136 Centralia Ct Ste 103, Leesburg, FL 34788-3757 | 2019-11-25 |
| 1306488820 | Alberto Rivera-sanchez Pa | Pain Medicine | 201 W Canton Ave Ste 275, Winter Park, FL 32789-3148 | 2019-10-16 |
| 1912560798 | Jacksonville Spine Center Pa | Pain Medicine | 2349 Village Square Pkwy Ste 107, Fleming Island, FL 32003-4319 | 2019-04-17 |
| 1942765144 | Nixpain LLC | Pain Medicine | 2750 Ne 14th St, Fort Lauderdale, FL 33304-1611 | 2019-02-01 |
| 1346737749 | Ceda Orthopedics Group, LLC. | Pain Medicine | 815 Nw 57th Avenue, Ste. 202, Miami, FL 33126 | 2018-04-20 |
| 1174025001 | Lighthouse Point Surgery Center LLC | Pain Medicine | 1821 Ne 25th St Ste 100, Lighthouse Point, FL 33064-7744 | 2018-03-07 |
| 1801394440 | Neuspine Therapy LLC | Pain Medicine | 12880 Us 301, Dade City, FL 33525-5801 | 2018-01-29 |
| Find all providers with the same taxonomy | ||||
| City | PINELLAS PARK |
| Zip Code | 33781 |
Please comment or provide details below to improve the information on IVAN SAMCAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.