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Marlene Y Samuels, MED-WAIVERPROVIDER
Developmental Disabilities Clinic/Center in Port St Lucie, Florida
NPI 1174037592

Marlene Y Samuels is a Developmental Disabilities Clinic/Center based in Port St Lucie, FL and is specialized in Developmental Disabilities. Marlene Y Samuels practices in Port St Lucie, FL and has the professional credentials of MED-WAIVERPROVIDER. The NPI Number for Marlene Y Samuels is 1174037592 and holds a License No. (Florida).

The current practice location address for Marlene Y Samuels is 4241 Sw Hagaplan St, Port St Lucie, FL and can be reached out via phone at 772-224-4466.

Location: 4241 Sw Hagaplan St, Port St Lucie, FL, 34953-6583
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174037592
Provider Name
Marlene Y Samuels
Credential
MED-WAIVERPROVIDER
Provider Entity Type
Individual
Gender
Female
Address
4241 Sw Hagaplan St, Port St Lucie, FL, 34953-6583
Phone Number
772-224-4466
Fax Number
Provider Enumeration Date
11/21/2017
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
261QD1600X 05 FL
institution
Provider Business Practice Location Address Details
Address
4241 Sw Hagaplan St
City
Port St Lucie
State
Florida
Zip
34953-6583
Phone Number
772-224-4466
Fax Number
person
Provider Business Mailing Address Details
Address
4241 Sw Hagaplan St
City
Port St Lucie
State
Florida
Zip
34953-6583
Phone Number
772-224-4466
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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