Provider Demographics
NPI:1871860585
Name:SIMAS, KEVIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:SIMAS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 CORPORATE AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3504
Mailing Address - Country:US
Mailing Address - Phone:954-385-7322
Mailing Address - Fax:954-385-7324
Practice Address - Street 1:3300 CORPORATE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3504
Practice Address - Country:US
Practice Address - Phone:954-385-7322
Practice Address - Fax:954-385-7324
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS22260183500000X
NY36985183500000X
FLPU36191835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist