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General NPI Number Information
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NPI Number | 1043708191
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Entity Type | Individual
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Provider Name | WAYNE SIMMONS DO
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Gender | Male
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 502 W HIGHLAND BLVD
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City | INVERNESS
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State | FL
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Zip | 34452-4720
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Country | US
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Telephone | 801-358-5236
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Fax |
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Provider Business Mailing Address
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Address Line | 10995 E MOORES HAMMOCK CT
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City | INVERNESS
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State | FL
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Zip | 34450-8226
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Country | US
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Telephone | 801-358-5236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | OS19068
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License Number State | FL
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