MEDICARE: SIBYL K. SIMON, M.D., P.L.

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	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	ME108534	FL
2	2084P0800X	Psychiatry Physician	ME108534	FL

General Provider Information

NPI Number	:	1871921098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIBYL K. SIMON, M.D., P.L.

Provider Business Mailing Address
First Line	:	9600 W SAMPLE RD
Second Line	:	SUITE 506
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4045
Country	:	US
Telephone Number	:	954-800-7836
Fax Number	:	950-800-7837

Provider Business Practice Location Address
First Line	:	9600 W SAMPLE RD
Second Line	:	SUITE 506
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4045
Country	:	US
Telephone Number	:	954-800-7836
Fax Number	:	950-800-7837

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SIBYL SIMON
Credential	:	MD
Telephone Number	:	954-800-7836

Provider Enumeration Date	:	10/25/2013
Last Update Date	:	10/25/2013

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