Provider Demographics
NPI:1275665010
Name:ROBERT D. SIMON M.D.P.A.
Entity Type:Organization
Organization Name:ROBERT D. SIMON M.D.P.A.
Other - Org Name:CENTER FOR ORTHOPEDIC SURGERY AND SPORTS MEDICINE OF SOUTH FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-845-7078
Mailing Address - Street 1:701 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5215
Mailing Address - Country:US
Mailing Address - Phone:561-845-7078
Mailing Address - Fax:561-847-8030
Practice Address - Street 1:701 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5215
Practice Address - Country:US
Practice Address - Phone:561-845-7078
Practice Address - Fax:561-847-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL41718AMedicare ID - Type Unspecified
FLF95108Medicare UPIN