Doctor Name: | DR. MATTHEW D SIMON |
NPI Number: | 1013990266 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | PY6724 |
Business Practice Address: | 7469 Nw 4th St Plantation, FL - 333172216 |
Business Phone Number: | 9547920772 |
Business Fax Number: | 9547921221 |
Mailing Address: | 7469 Nw 4th St, PLANTATION |
State: | FL |
Postal Code: | 333172216 |
Phone Number: | 9547920772 |
Fax Number: | 9547921221 |
NPI Enumeration Date: | 11/22/2005 |
NPI Last Update Date: | 09/27/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY6724 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |