MEDICARE: DR. TOBY L SIMON MD

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	207ZB0001X	Blood Banking & Transfusion Medicine Physician	ME97808	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	220031501	OTHER		MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	NM009U29	OTHER	NM	BLUE SHIELD

General Provider Information

NPI Number	:	1528084571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOBY L SIMON MD

Provider Business Mailing Address
First Line	:	900 BROKEN SOUND PKWY
Second Line	:	STE 400
City	:	BOCA RATON
State	:	FL
Zip	:	33487-3513
Country	:	US
Telephone Number	:	561-859-9315
Fax Number	:	610-290-9104

Provider Business Practice Location Address
First Line	:	900 BROKEN SOUND PKWY
Second Line	:	STE 400
City	:	BOCA RATON
State	:	FL
Zip	:	33487-3513
Country	:	US
Telephone Number	:	561-859-9315
Fax Number	:	610-290-9104

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	08/22/2013

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Directions to “ DR. TOBY L SIMON MD” Practice Location

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