Provider Demographics
NPI:1881471704
Name:BLAIN - MAIZA, SAMANTHA KRISTINE (DNP)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:KRISTINE
Last Name:BLAIN - MAIZA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1651 W 37TH ST STE 308
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4692
Mailing Address - Country:US
Mailing Address - Phone:786-383-2443
Mailing Address - Fax:305-280-8261
Practice Address - Street 1:1651 W 37TH ST STE 308
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4692
Practice Address - Country:US
Practice Address - Phone:786-383-2443
Practice Address - Fax:305-280-8261
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11028556363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner