MEDICARE: MR. BRIAN C SIMMONS HAS

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	237700000X	Hearing Instrument Specialist	AS5138	FL

General Provider Information

NPI Number	:	1982433561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN C SIMMONS HAS

Provider Business Mailing Address
First Line	:	5585 STEWART ST
Second Line	:
City	:	MILTON
State	:	FL
Zip	:	32570-4344
Country	:	US
Telephone Number	:	850-476-1502
Fax Number	:	850-476-1504

Provider Business Practice Location Address
First Line	:	5585 STEWART ST
Second Line	:
City	:	MILTON
State	:	FL
Zip	:	32570-4344
Country	:	US
Telephone Number	:	850-476-1502
Fax Number	:	850-476-1504

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

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	07/31/2024

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