Healthcare Provider Details

I. General information

NPI: 1710813464
Provider Name (Legal Business Name): DIEUNANE SIMEUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6072 ADRIATIC WAY
GREENACRES FL
33413-1083
US

IV. Provider business mailing address

6072 ADRIATIC WAY
GREENACRES FL
33413-1083
US

V. Phone/Fax

Practice location:
  • Phone: 561-932-8286
  • Fax:
Mailing address:
  • Phone: 561-932-8286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11048614
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: