Healthcare Provider Details

I. General information

NPI: 1396980397
Provider Name (Legal Business Name): SIMI GEORGE (M.D.)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 BUDINGER AVE STE 100
SAINT CLOUD FL
34769-4123
US

IV. Provider business mailing address

1330 BUDINGER AVE STE 100
SAINT CLOUD FL
34769-4123
US

V. Phone/Fax

Practice location:
  • Phone: 407-498-3540
  • Fax: 321-843-5863
Mailing address:
  • Phone: 407-498-3540
  • Fax: 321-843-5863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME116521
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: