Provider Demographics
NPI:1336315738
Name:C NORTON SIMS MD
Entity Type:Organization
Organization Name:C NORTON SIMS MD
Other - Org Name:C NORTON SIMS MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:NORTON
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-939-1345
Mailing Address - Street 1:3949 EVANS AV
Mailing Address - Street 2:STE 106
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9341
Mailing Address - Country:US
Mailing Address - Phone:239-939-1345
Mailing Address - Fax:239-939-3675
Practice Address - Street 1:3949 EVANS AV
Practice Address - Street 2:STE 106
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9341
Practice Address - Country:US
Practice Address - Phone:239-939-1345
Practice Address - Fax:239-939-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME13800332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0849490001Medicare NSC