Provider Demographics
NPI:1437802519
Name:LUMSDEN, SIMONE ELIZABETH ASHLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:ELIZABETH ASHLEY
Last Name:LUMSDEN
Suffix:
Gender:F
Credentials:PA-C
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9980 CENTRAL PARK BLVD N STE 322
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1704
Mailing Address - Country:US
Mailing Address - Phone:561-488-2988
Mailing Address - Fax:561-498-1619
Practice Address - Street 1:9980 CENTRAL PARK BLVD N STE 322
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1704
Practice Address - Country:US
Practice Address - Phone:561-488-2988
Practice Address - Fax:561-498-1619
Is Sole Proprietor?:No
Enumeration Date:2022-01-30
Last Update Date:2022-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9115476363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant