Provider Demographics
NPI:1861458168
Name:SIMMONS, JEFFREY DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DEAN
Last Name:SIMMONS
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 1:7200 CORPORATE CENTER DR
Mailing Address - Street 2:#600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1200
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:5643 NW 29TH ST
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-1531
Practice Address - Country:US
Practice Address - Phone:954-979-6900
Practice Address - Fax:954-970-2561
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 61682207RC0000X
FLME61692207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379930100Medicaid
FL18107COtherMEDICARE AVENTURA
FL18107ROtherMEDICARE NORTH MIAMI
FL18107DOtherMEDICARE PEMBROKE
FL18107KOtherMEDICARE BISCAYNE
FL379930100Medicaid
FL18107NMedicare UPIN