MEDICARE: SIBYL K 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	2084P0800X	Psychiatry Physician	ME108534	FL
2	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	ME108534	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	:	1790949881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIBYL K SIMON MD

Provider Business Mailing Address
First Line	:	9600 W SAMPLE RD
Second Line	:	SUITE 305
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4045
Country	:	US
Telephone Number	:	954-800-7836
Fax Number	:	954-800-7837

Provider Business Practice Location Address
First Line	:	9600 W SAMPLE RD
Second Line	:	SUITE 305
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4045
Country	:	US
Telephone Number	:	954-800-7836
Fax Number	:	954-800-7837

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

Provider Enumeration Date	:	07/17/2008
Last Update Date	:	10/25/2016

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