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General NPI Number Information
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NPI Number | 1770862567
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Entity Type | Individual
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Provider Name | REGINOLD LEVI SIMMONS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 10/26/2025
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Provider Practice Location Address
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Address Line | 400 TEDDER ROAD
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City | CENTURY
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State | FL
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Zip | 32535
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Country | US
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Telephone | 850-256-1784
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Fax | 850-256-1319
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Provider Business Mailing Address
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Address Line | 400 TEDDER ROAD
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City | CENTURY
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State | FL
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Zip | 32535
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Country | US
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Telephone | 850-256-1784
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Fax | 850-256-1319
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME35623
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License Number State | FL
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