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NPI Code Detail

MEDICARE: MR. SIMON PHILIP

MEDICARE: MR. SIMON PHILIP
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
1363LA2100XAcute Care Nurse PractitionerAPRN11042999FL

General Provider Information

NPI Number : 1730028051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SIMON PHILIP
Provider Business Mailing Address
First Line : 1010 SINGLETON BLVD APT 1061
Second Line :
City : DALLAS
State : TX
Zip : 75212-4715
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 SE HOSPITAL AVE
Second Line :
City : STUART
State : FL
Zip : 34994-2346
Country : US
Telephone Number : 772-287-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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