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General NPI Number Information
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NPI Number | 1063133544
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Entity Type | Individual
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Provider Name | MONTANA SIMMONS
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Gender | Female
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 880 SW 145TH AVE STE 202
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-6171
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Country | US
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Telephone | 866-849-0692
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Fax |
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Provider Business Mailing Address
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Address Line | 4121 RESIDENCE DR APT 303
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City | FORT MYERS
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State | FL
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Zip | 33901-9234
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2025034516
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11021703
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1212142
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License Number State | TX
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