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NPI Code Detail

MEDICARE: WALTER SIMMONS DO

MEDICARE: WALTER SIMMONS DO
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
1207P00000XEmergency Medicine PhysicianOS0009228FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
143181OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902878952
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER SIMMONS DO
Provider Business Mailing Address
First Line : PO BOX 2147
Second Line :
City : FORT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 393-433-2922
Fax Number : 239-343-3695
Provider Business Practice Location Address
First Line : 13681 DOCTORS WAY
Second Line :
City : FT MYERS
State : FL
Zip : 33912-4300
Country : US
Telephone Number : 239-768-8611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 06/15/2022

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