MEDICARE: ROBERT DANIEL SIMON MD

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	207X00000X	Orthopaedic Surgery Physician	ME0073142	FL

General Provider Information

NPI Number	:	1699857466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT DANIEL SIMON MD

Provider Business Mailing Address
First Line	:	701 NORTHLAKE BLVD
Second Line	:	SUITE 208
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5215
Country	:	US
Telephone Number	:	561-845-7078
Fax Number	:	561-845-8030

Provider Business Practice Location Address
First Line	:	701 NORTHLAKE BLVD
Second Line	:	SUITE 208
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5215
Country	:	US
Telephone Number	:	561-845-7078
Fax Number	:	561-845-8030

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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