MEDICARE: MARK ALLEN SIMS M.D.

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	174400000X	Specialist	ME0031653	FL

General Provider Information

NPI Number	:	1922041375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ALLEN SIMS M.D.

Provider Business Mailing Address
First Line	:	600 UNIVERSITY BLVD
Second Line	:	SUITE 200
City	:	JUPITER
State	:	FL
Zip	:	33458-2778
Country	:	US
Telephone Number	:	561-747-8995
Fax Number	:	561-747-2119

Provider Business Practice Location Address
First Line	:	600 UNIVERSITY BLVD
Second Line	:	SUITE 200
City	:	JUPITER
State	:	FL
Zip	:	33458-2778
Country	:	US
Telephone Number	:	561-747-8995
Fax Number	:	561-747-2119

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	11/05/2012

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