MEDICARE: MICHAEL A 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	208800000X	Urology Physician	ME89935	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	P00956378	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0195189	OTHER	FL	GHI
2	1193472	OTHER	FL	WELLCARE
3	773707	OTHER	FL	NHP
4	P0003130	OTHER	FL	FLORIDA HEALTHCARE PLUS
5	2116456	OTHER	FL	CIGNA
6	298813	OTHER	FL	AVMED
7	7072759	OTHER	FL	AETNA
8	M899351	OTHER	FL	PREFERRED MEDICAL PLAN
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	50359	OTHER	FL	BLUE CROSS BLUE SHIELD
12	69212	OTHER	FL	HEALTH SUN HEALTH PLAN
13	M899353	OTHER	FL	PREFERRED MEDICAL PLAN
14	SG078455	OTHER	FL	VISTA
15	20784	OTHER	FL	MEDICA
16	P01712888	OTHER	FL	SIMPLY HEALTHCARE
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700885761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL A SIMON MD

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: MANAGED CARE DEPT.
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	1951 SW 172ND AVE
Second Line	:	SUITE 300
City	:	MIRAMAR
State	:	FL
Zip	:	33029-5593
Country	:	US
Telephone Number	:	954-499-7696
Fax Number	:	954-499-7699

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	05/08/2017

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Directions to “ MICHAEL A SIMON MD” Practice Location

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