Healthcare Provider Details

I. General information

NPI: 1285128496
Provider Name (Legal Business Name): SIMEDHEALTH, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 W. NEWBERRY ROAD SUITE 10
GAINESVILLE FL
32607-2817
US

IV. Provider business mailing address

PO BOX 357010
GAINESVILLE FL
32635-7010
US

V. Phone/Fax

Practice location:
  • Phone: 352-373-2340
  • Fax: 352-373-3140
Mailing address:
  • Phone: 352-224-2200
  • Fax: 352-224-2484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME080634
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME72829
License Number StateFL

VIII. Authorized Official

Name: MR. DANIEL MARTIN DUNCANSON
Title or Position: CEO
Credential: M.D.
Phone: 352-224-2302