Individual ProviderAngela Mary-Riad SamuelPediatricsAllopathic & Osteopathic PhysiciansPractice Address9611 W Broward Blvd, Plantation, FL 33324-2334(954) 424-7000(813) 689-7571PECOS EnrollmentBased on the most recent information from CMS, provider Angela Mary-Riad Samuel does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 15 days ago.Profile DetailsProvider ID1043657968Provider TypeIndividualFull NameSamuel, Angela Mary-RiadTitleDr.CredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date6/1/2013Last Updated7/6/2023Contact InformationPractice LocationPractice Address9611 W Broward Blvd, Plantation, FL 33324-2334Phone(954) 424-7000FaxUnlisted FaxMailing LocationMailing Address11260 Sullivan St, Riverview, FL 33578-2140Phone(813) 689-7571FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseME133485FloridaCode208000000XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense125-062979IllinoisProvider IdentifiersIDDescriptionIssuerID101269100DescriptionMedicaidIssuerUnlistedFlorida