Provider Demographics
NPI:1093272981
Name:SIMMS, ALLEN STEVEN (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:STEVEN
Last Name:SIMMS
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8513 BERNWOOD COVE LOOP APT 203
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-8141
Mailing Address - Country:US
Mailing Address - Phone:239-703-5524
Mailing Address - Fax:
Practice Address - Street 1:2855 COLONIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1012
Practice Address - Country:US
Practice Address - Phone:239-334-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL43762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer