Healthcare Provider Details

I. General information

NPI: 1871921098
Provider Name (Legal Business Name): SIBYL K. SIMON, M.D., P.L.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2013
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 W SAMPLE RD SUITE 506
CORAL SPRINGS FL
33065-4045
US

IV. Provider business mailing address

9600 W SAMPLE RD SUITE 506
CORAL SPRINGS FL
33065-4045
US

V. Phone/Fax

Practice location:
  • Phone: 954-800-7836
  • Fax: 950-800-7837
Mailing address:
  • Phone: 954-800-7836
  • Fax: 950-800-7837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME108534
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberME108534
License Number StateFL

VIII. Authorized Official

Name: DR. SIBYL SIMON
Title or Position: OWNER
Credential: MD
Phone: 954-800-7836