Healthcare Provider Details

I. General information

NPI: 1134050487
Provider Name (Legal Business Name): SIMONE PSYCHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 S PALM AVE STE 1-212
MIRAMAR FL
33025-5091
US

IV. Provider business mailing address

1101 NW 155TH TER
PEMBROKE PINES FL
33028-1581
US

V. Phone/Fax

Practice location:
  • Phone: 754-329-5644
  • Fax:
Mailing address:
  • Phone: 754-329-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SIMONE MARIA BURGOS-JUTERAM
Title or Position: PMHNP
Credential: PMHNP
Phone: 754-329-5644