Provider Demographics
NPI:1447201413
Name:SIMON, SEAN ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ADAM
Last Name:SIMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 SUNSET DR
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4805
Mailing Address - Country:US
Mailing Address - Phone:305-668-0496
Mailing Address - Fax:305-667-7459
Practice Address - Street 1:6200 SUNSET DR
Practice Address - Street 2:SUITE 501
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4805
Practice Address - Country:US
Practice Address - Phone:305-668-0496
Practice Address - Fax:305-667-7459
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL91069208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery