Provider Demographics
NPI:1649410150
Name:SIMA, NEIL CHRISTOPHER (PA-C)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:CHRISTOPHER
Last Name:SIMA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 NEBRASKA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4832
Mailing Address - Country:US
Mailing Address - Phone:772-465-8100
Mailing Address - Fax:772-465-8689
Practice Address - Street 1:2100 NEBRASKA AVE STE 201
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4832
Practice Address - Country:US
Practice Address - Phone:772-465-8100
Practice Address - Fax:772-465-8689
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363AS0400X
FLPA9114314363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0741648Medicaid