MEDICARE: WARREN L. SIMMONDS, DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	PO345	FL

General Provider Information

NPI Number	:	1053582338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARREN L. SIMMONDS, DPM

Provider Business Mailing Address
First Line	:	1111 KANE CONCOURSE
Second Line	:	SUITE 111
City	:	BAY HARBOR ISLAND
State	:	FL
Zip	:	33154-2039
Country	:	US
Telephone Number	:	305-866-9608
Fax Number	:	305-866-1750

Provider Business Practice Location Address
First Line	:	1111 KANE CONCOURSE
Second Line	:	SUITE 111
City	:	BAY HARBOR ISLAND
State	:	FL
Zip	:	33154-2039
Country	:	US
Telephone Number	:	305-866-9608
Fax Number	:	305-866-1750

Authorized Official
Title or Position	:	QWNER
Name	:	WARREN L SIMMONDS
Credential	:	DPM
Telephone Number	:	305-866-9608

Provider Enumeration Date	:	03/14/2008
Last Update Date	:	03/14/2008

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