MEDICARE: SEAN A. SIMON, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	ME91069	FL

General Provider Information

NPI Number	:	1184634321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEAN A. SIMON, M.D., P.A.

Provider Business Mailing Address
First Line	:	6250 SUNSET DR
Second Line	:	SUITE 200
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4807
Country	:	US
Telephone Number	:	305-668-0496
Fax Number	:	305-667-7459

Provider Business Practice Location Address
First Line	:	6250 SUNSET DR
Second Line	:	SUITE 200
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4807
Country	:	US
Telephone Number	:	305-668-0496
Fax Number	:	305-667-7459

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SEAN ADAM SIMON
Credential	:	MD
Telephone Number	:	305-668-0496

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/22/2020

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