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NPI Code Detail

MEDICARE: DR. RUSSELL PHILLIP SIMON M.D.

MEDICARE: DR. RUSSELL PHILLIP SIMON M.D.
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
1207RC0000XCardiovascular Disease PhysicianME162673FL

General Provider Information

NPI Number : 1518498526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUSSELL PHILLIP SIMON M.D.
Provider Business Mailing Address
First Line : 7593 W BOYNTON BEACH BLVD STE 220
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-6162
Country : US
Telephone Number : 561-678-2652
Fax Number : 888-316-2198
Provider Business Practice Location Address
First Line : 5401 S CONGRESS AVE STE 102
Second Line :
City : ATLANTIS
State : FL
Zip : 33462-6636
Country : US
Telephone Number : 561-967-5033
Fax Number : 561-967-5424
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2017
Last Update Date : 06/12/2023

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Directions to “ DR. RUSSELL PHILLIP SIMON M.D.” Practice Location

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