Healthcare Provider Details

I. General information

NPI: 1881156149
Provider Name (Legal Business Name): REMIL SIMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19415 DEERFIELD AVE STE 106
LANSDOWNE VA
20176-8470
US

IV. Provider business mailing address

19415 DEERFIELD AVE STE 106
LANSDOWNE VA
20176-8470
US

V. Phone/Fax

Practice location:
  • Phone: 703-723-9633
  • Fax: 703-723-9772
Mailing address:
  • Phone: 703-723-9633
  • Fax: 703-723-9772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number11923
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101277548
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: