Doctor Name: | SHELIA SIMMONS |
NPI Number: | 1003218652 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 142 Bell St Havana, FL - 323336360 |
Business Phone Number: | 8502125612 |
Business Fax Number: | |
Mailing Address: | 142 Bell St, HAVANA |
State: | FL |
Postal Code: | 323336360 |
Phone Number: | 8502125612 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2014 |
NPI Last Update Date: | 09/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |