Provider Demographics
NPI:1952042731
Name:DAVIS, SIMONE P
Entity Type:Individual
Prefix:MISS
First Name:SIMONE
Middle Name:P
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 773986
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33077-3986
Mailing Address - Country:US
Mailing Address - Phone:908-265-3670
Mailing Address - Fax:
Practice Address - Street 1:1075 RIVERSIDE DR APT 505
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7022
Practice Address - Country:US
Practice Address - Phone:908-265-3670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health