Healthcare Provider Details

I. General information

NPI: 1629615133
Provider Name (Legal Business Name): SIMON HEALTH MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 W FLAGLER ST STE 124
MIAMI FL
33144-2096
US

IV. Provider business mailing address

8300 W FLAGLER ST STE 124
MIAMI FL
33144-2096
US

V. Phone/Fax

Practice location:
  • Phone: 305-877-6650
  • Fax:
Mailing address:
  • Phone: 305-877-6650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: REGIS R SOLENZAL VALDES
Title or Position: OWNER/PRESIDENT
Credential: OWNER
Phone: 305-877-6650