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General NPI Number Information
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NPI Number | 1205333879
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Entity Type | Individual
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Provider Name | MICHAEL SIMON DO
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Gender | Male
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 303 N CLYDE MORRIS BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2709
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Country | US
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Telephone | 386-254-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 8 STRATHMORE DR
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City | NORTH BABYLON
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State | NY
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Zip | 11703-3713
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 317540
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | OS20954
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License Number State | FL
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