Provider Demographics
NPI:1053188144
Name:RAINFORD, SAMANTHA (RN, BSN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:RAINFORD
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4723 NW 48TH TER
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3631
Mailing Address - Country:US
Mailing Address - Phone:954-825-9475
Mailing Address - Fax:
Practice Address - Street 1:4723 NW 48TH TER
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-3631
Practice Address - Country:US
Practice Address - Phone:954-825-9475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9468601163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse