Provider Demographics
NPI:1366884660
Name:NOTMAN, SAMANTHA (DO)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:
Last Name:NOTMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:LECKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13737 AMERICAN PRAIRIE PL
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-2603
Mailing Address - Country:US
Mailing Address - Phone:941-725-0022
Mailing Address - Fax:
Practice Address - Street 1:8470 COOPER CREEK BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-2020
Practice Address - Country:US
Practice Address - Phone:941-500-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-27
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13037207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIR268ZMedicare PIN