Provider Demographics
NPI:1184634321
Name:SEAN A. SIMON, M.D., P.A.
Entity Type:Organization
Organization Name:SEAN A. SIMON, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-668-0496
Mailing Address - Street 1:6250 SUNSET DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4807
Mailing Address - Country:US
Mailing Address - Phone:305-668-0496
Mailing Address - Fax:305-667-7459
Practice Address - Street 1:6250 SUNSET DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4807
Practice Address - Country:US
Practice Address - Phone:305-668-0496
Practice Address - Fax:305-667-7459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91069208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty