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General NPI Number Information
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NPI Number | 1316647597
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Entity Type | Individual
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Provider Name | SAMANTHA NICOLE SIMON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 201 N UNIVERSITY DR STE 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 | 544-722-0119
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N UNIVERSITY DR STE 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 | 954-472-2011
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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 | APRN04108
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License Number State | RI
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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 | 11025072
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License Number State | FL
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