Provider Demographics
NPI:1114180668
Name:SIMMS, CHRISTOPHER J (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:SIMMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9517 CAVENDISH DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-5152
Mailing Address - Country:US
Mailing Address - Phone:813-215-0084
Mailing Address - Fax:
Practice Address - Street 1:9517 CAVENDISH DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-5152
Practice Address - Country:US
Practice Address - Phone:813-215-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-04
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist