Provider Demographics
NPI:1326028515
Name:SIMON, ARNOLD JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:JAY
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MRS
Other - First Name:PAZ
Other - Middle Name:ABAYA
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3175 S CONGRESS AVE
Mailing Address - Street 2:SUITE #305
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2500
Mailing Address - Country:US
Mailing Address - Phone:561-641-7486
Mailing Address - Fax:561-641-6196
Practice Address - Street 1:3175 S CONGRESS AVE
Practice Address - Street 2:SUITE #305
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2500
Practice Address - Country:US
Practice Address - Phone:561-641-7486
Practice Address - Fax:561-641-6196
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036884207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD65254Medicare UPIN
61224Medicare ID - Type Unspecified