Provider Demographics
NPI:1396817797
Name:SIMEONI, ANNA M (DDS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:M
Last Name:SIMEONI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82969
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33682-2969
Mailing Address - Country:US
Mailing Address - Phone:813-866-0930
Mailing Address - Fax:813-866-0929
Practice Address - Street 1:1514 N FLORIDA AVE
Practice Address - Street 2:STE 300
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-2602
Practice Address - Country:US
Practice Address - Phone:813-490-1957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHAD 701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice