Provider Demographics
NPI:1679198873
Name:LAFUENTE, SAMANTHA ELIZABETH (DNP)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ELIZABETH
Last Name:LAFUENTE
Suffix:
Gender:
Credentials:DNP
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:ZIESK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3342 SW HOSANAH LN
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974-2218
Mailing Address - Country:US
Mailing Address - Phone:904-891-4028
Mailing Address - Fax:
Practice Address - Street 1:1701 SE HILLMOOR DR STE 7
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7552
Practice Address - Country:US
Practice Address - Phone:772-480-5860
Practice Address - Fax:772-264-8310
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007279363LA2100X, 363LG0600X, 363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11007279OtherFLORIDA BOARD OF NURSING