| Doctor Name: | DR. SAMANTHA LARSON ANELLO |
| NPI Number: | 1043659063 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT27903 |
| Business Practice Address: | 3316 3rd St S Suite 104 Jacksonville Beach, FL - 322506073 |
| Business Phone Number: | 9046858109 |
| Business Fax Number: | 9042490907 |
| Mailing Address: | 1763 Sunset Dr, JACKSONVILLE BEACH |
| State: | FL |
| Postal Code: | 322502983 |
| Phone Number: | 9048592978 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2013 |
| NPI Last Update Date: | 06/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT27903 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |