MEDICARE: DR. JOSHUA ADRIAN SIMON D.O.

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	208600000X	Surgery Physician	OS14617	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356766554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA ADRIAN SIMON D.O.

Provider Business Mailing Address
First Line	:	4801 LINTON BLVD STE 10A
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6501
Country	:	US
Telephone Number	:	561-708-4488
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 LINTON BLVD STE 10A
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6501
Country	:	US
Telephone Number	:	561-843-6586
Fax Number	:

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

Provider Enumeration Date	:	02/25/2014
Last Update Date	:	05/26/2026

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