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General NPI Number Information
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NPI Number | 1154585016
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Entity Type | Organization
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Legal Business Name | DAVID R SIMON MD PHD PA
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 201 N UNIVERSITY DR SUITE 106
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City | PLANTATION
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State | FL
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Zip | 33324-2039
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Country | US
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Telephone | 954-472-2007
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Fax | 954-472-2114
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Provider Business Mailing Address
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Address Line | 201 N UNIVERSITY DR SUITE 106
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City | PLANTATION
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State | FL
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Zip | 33324-2039
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Country | US
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Telephone | 954-472-2007
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Fax | 954-472-2114
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. DAVID R SIMON
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Credential | MD PHD
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Telephone | 954-472-2007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME0024567
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License Number State | FL
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