Doctor Name: | ROBERTO FERNANDO SIMONI |
NPI Number: | 1174898951 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 160 Ave Munoz Rivera Local #4 Camuy, PR - 00627 |
Business Phone Number: | 7873905055 |
Business Fax Number: | |
Mailing Address: | 425 Road 693, Pmb 218, DORADO |
State: | PR |
Postal Code: | 00646 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/13/2012 |
NPI Last Update Date: | 03/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1201X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optometric Assistant |
Taxonomy Definition: |