Healthcare Provider Details

I. General information

NPI: 1174100259
Provider Name (Legal Business Name): NATHALIE RODRIGUES SIMOES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5570 RANGELINE RD
MOBILE AL
36619-9540
US

IV. Provider business mailing address

5570 RANGELINE RD
MOBILE AL
36619-9540
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-8623
  • Fax:
Mailing address:
  • Phone: 603-650-8623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number53477
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: