MEDICARE: ANGELINE SIMEUS OD

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	152W00000X	Optometrist	3519-35	WI
2	152W00000X	Optometrist	OPC5739	FL

General Provider Information

NPI Number	:	1689160350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELINE SIMEUS OD

Provider Business Mailing Address
First Line	:	11058 GRANDE PINES CIR APT 823
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-9333
Country	:	US
Telephone Number	:	813-355-9543
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 1ST ST N STE 100
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4507
Country	:	US
Telephone Number	:	863-299-8908
Fax Number	:

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

Provider Enumeration Date	:	07/06/2018
Last Update Date	:	07/04/2020

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Directions to “ ANGELINE SIMEUS OD” Practice Location

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