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NPI Code Detail

MEDICARE: DR. RUTH SIMON

MEDICARE:  DR. RUTH  SIMON
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
1363LF0000XFamily Nurse PractitionerAPRN11004744FL

General Provider Information

NPI Number : 1518503044
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUTH SIMON
Provider Business Mailing Address
First Line : 3029 SE GALT CIR
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34984-6339
Country : US
Telephone Number : 772-626-7044
Fax Number :
Provider Business Practice Location Address
First Line : 3029 SE GALT CIR
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34984-6339
Country : US
Telephone Number : 772-626-7044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2019
Last Update Date : 11/19/2019

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Directions to “ DR. RUTH SIMON ” Practice Location

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