Provider Demographics
NPI:1821679929
Name:SIMONA B BARTOS DO PA
Entity Type:Organization
Organization Name:SIMONA B BARTOS DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BARTOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-937-2294
Mailing Address - Street 1:4700 SHERIDAN STREET
Mailing Address - Street 2:STE I
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3416
Mailing Address - Country:US
Mailing Address - Phone:954-937-2294
Mailing Address - Fax:
Practice Address - Street 1:4700 SHERIDAN STREET
Practice Address - Street 2:STE I
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3416
Practice Address - Country:US
Practice Address - Phone:954-937-2294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty