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General NPI Number Information
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NPI Number | 1801874896
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Entity Type | Individual
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Provider Name | BRAD DAVID SIMONS MD PHD PA
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Gender | Male
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 04/19/2020
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Provider Practice Location Address
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Address Line | 2141 S HIGHWAY A1A ALT STE 210 THREE PALMS CENTER
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City | JUPITER
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State | FL
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Zip | 33477-4072
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Country | US
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Telephone | 561-747-4100
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Fax | 561-747-8822
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Provider Business Mailing Address
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Address Line | 2141 S HIGHWAY A1A ALT STE 210 THREE PALMS CENTER
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City | JUPITER
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State | FL
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Zip | 33477-4072
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Country | US
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Telephone | 561-747-4100
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Fax | 561-747-8822
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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 | 207WX0110X
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Taxonomy Name | Pediatric Ophthalmology and Strabismus Specialist Physician Physician
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License Number | ME76183
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME76183
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License Number State | FL
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