Provider Demographics
NPI:1275796518
Name:SIMPSON-DARROUX, MELANIE R (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:R
Last Name:SIMPSON-DARROUX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6635 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3354
Mailing Address - Country:US
Mailing Address - Phone:561-434-5678
Mailing Address - Fax:561-964-9829
Practice Address - Street 1:3505 PROGRESS LN
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6519
Practice Address - Country:US
Practice Address - Phone:407-891-8044
Practice Address - Fax:407-891-8016
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME112274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014139200Medicaid