Healthcare Provider Details

I. General information

NPI: 1841237567
Provider Name (Legal Business Name): ROBERT SHAW SIMKINS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 S SEACREST BLVD
BOYNTON BEACH FL
33435-7934
US

IV. Provider business mailing address

270 12TH MNR APT 103
VERO BEACH FL
32960-7053
US

V. Phone/Fax

Practice location:
  • Phone: 561-737-7733
  • Fax:
Mailing address:
  • Phone: 772-559-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP2170492
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number616152
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: