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NPI Code Detail

MEDICARE: JOSE ANTONIO C SIM

MEDICARE: JOSE ANTONIO C SIM
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
1363LF0000XFamily Nurse Practitioner302492AZ

General Provider Information

NPI Number : 1528825585
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE ANTONIO C SIM
Provider Business Mailing Address
First Line : 2415 E CAMELBACK RD STE 700
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-4245
Country : US
Telephone Number : 602-342-8481
Fax Number : 602-342-8328
Provider Business Practice Location Address
First Line : 2415 E CAMELBACK RD STE 700
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-4245
Country : US
Telephone Number : 602-342-8481
Fax Number : 602-342-8328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2024
Last Update Date : 02/02/2026

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Directions to “ JOSE ANTONIO C SIM ” Practice Location

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