Provider Demographics
NPI:1871014977
Name:SIMSOVIC, STEPHANIE (DC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SIMSOVIC
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SHORES DR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-3905
Mailing Address - Country:US
Mailing Address - Phone:787-363-9019
Mailing Address - Fax:
Practice Address - Street 1:2092 6TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-0906
Practice Address - Country:US
Practice Address - Phone:787-363-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007632111N00000X
FL13474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor