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General NPI Number Information
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NPI Number | 1356908248
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Entity Type | Individual
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Provider Name | KRISTY SIMONETTI MD
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Gender | Female
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Dates
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Enumeration Date | 05/26/2019
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 13782 PLANTATION RD
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City | FORT MYERS
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State | FL
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Zip | 33912-4462
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Country | US
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Telephone | 239-343-1100
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Fax | 239-343-1101
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-1100
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Fax | 239-343-1101
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME158487
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License Number State | FL
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