Healthcare Provider Details

I. General information

NPI: 1831612548
Provider Name (Legal Business Name): SIMONA ERICA POSTELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIMONA DEVENISH

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 S US HIGHWAY 1
TEQUESTA FL
33469-2702
US

IV. Provider business mailing address

5466 THOMASVILLE RD
TALLAHASSEE FL
32312-3812
US

V. Phone/Fax

Practice location:
  • Phone: 561-743-3841
  • Fax:
Mailing address:
  • Phone: 850-893-8116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9356065
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: