Healthcare Provider Details

I. General information

NPI: 1447719984
Provider Name (Legal Business Name): VALERIE SIMON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 NW 95TH ST
MIAMI FL
33150-2063
US

IV. Provider business mailing address

2900 DOLPHIN DR
MIRAMAR FL
33025-2537
US

V. Phone/Fax

Practice location:
  • Phone: 305-696-9400
  • Fax:
Mailing address:
  • Phone: 954-600-9430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9329192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: