Healthcare Provider Details

I. General information

NPI: 1104743384
Provider Name (Legal Business Name): MONICA DEL CARMEN SIMON SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 SW 56TH ST STE 10
MIAMI FL
33165-7161
US

IV. Provider business mailing address

7353 S WATERWAY DR
MIAMI FL
33155-2705
US

V. Phone/Fax

Practice location:
  • Phone: 786-542-5774
  • Fax:
Mailing address:
  • Phone: 305-978-7290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13285
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: