Healthcare Provider Details

I. General information

NPI: 1417051954
Provider Name (Legal Business Name): SIMON T SYMEONIDES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW 1ST AVE
OCALA FL
34471-6516
US

IV. Provider business mailing address

1500 SW 1ST AVE
OCALA FL
34471-6516
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-7283
  • Fax: 407-303-0473
Mailing address:
  • Phone: 407-303-7283
  • Fax: 407-303-0473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME84573
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: