MEDICARE: BARRY M. SIMON, O.D., P.A.

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	152W00000X	Optometrist	OPC002327	FL

General Provider Information

NPI Number	:	1184946519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY M. SIMON, O.D., P.A.

Provider Business Mailing Address
First Line	:	3788 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9412
Country	:	US
Telephone Number	:	954-360-0033
Fax Number	:

Provider Business Practice Location Address
First Line	:	3788 W HILLSBORO BLVD
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9412
Country	:	US
Telephone Number	:	954-360-0033
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BARRY MARC SIMON
Credential	:	O.D.
Telephone Number	:	954-360-0033

Provider Enumeration Date	:	02/26/2010
Last Update Date	:	12/21/2012

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