MEDICARE: STEPHANIE SIMMS MA

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	101YM0800X	Mental Health Counselor	MH19626	FL

General Provider Information

NPI Number	:	1477983898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SIMMS MA

Provider Business Mailing Address
First Line	:	3662 AVALON PARK EAST BLVD STE 2024
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-7760
Country	:	US
Telephone Number	:	407-476-7450
Fax Number	:

Provider Business Practice Location Address
First Line	:	3662 AVALON PARK EAST BLVD STE 2024
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-7760
Country	:	US
Telephone Number	:	407-476-7450
Fax Number	:

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

Provider Enumeration Date	:	11/21/2013
Last Update Date	:	08/14/2023

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Directions to “ STEPHANIE SIMMS MA” Practice Location

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