Provider Demographics
NPI:1174189534
Name:SIMONS, SYNOVIA J (RDN)
Entity Type:Individual
Prefix:
First Name:SYNOVIA
Middle Name:J
Last Name:SIMONS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 MARSH VIEW DR UNIT 203
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4718
Mailing Address - Country:US
Mailing Address - Phone:813-847-9705
Mailing Address - Fax:
Practice Address - Street 1:2229 MARSH VIEW DR UNIT 203
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4718
Practice Address - Country:US
Practice Address - Phone:252-267-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-11
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9208133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty