Provider Demographics
NPI:1063001139
Name:ANDERSON SIMMS, FLORENCE (LMT)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:ANDERSON SIMMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 KARMA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4374
Mailing Address - Country:US
Mailing Address - Phone:407-286-9103
Mailing Address - Fax:
Practice Address - Street 1:301 N HIGHWAY 27 UNIT C
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2447
Practice Address - Country:US
Practice Address - Phone:407-286-9103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA70854225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist