MEDICARE: CHARIS SIMS

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1265167845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARIS SIMS

Provider Business Mailing Address
First Line	:	5350 ARLINGTON EXPY APT 504
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-6822
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13121 ATLANTIC BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-0103
Country	:	US
Telephone Number	:	904-491-2111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2022
Last Update Date	:	06/02/2026

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Directions to “ CHARIS SIMS ” Practice Location

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