Provider Demographics
NPI:1205943503
Name:SIMS, DANIEL JOHN (PT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JOHN
Last Name:SIMS
Suffix:
Gender:M
Credentials:PT
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 66977
Mailing Address - Street 2:
Mailing Address - City:ST PETE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33736-6977
Mailing Address - Country:US
Mailing Address - Phone:303-912-2777
Mailing Address - Fax:
Practice Address - Street 1:9149 ESTATE THOMAS
Practice Address - Street 2:SUITE 104, PARAGON MEDICAL BUILDING
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-714-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIVI-120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0057665Medicare ID - Type Unspecified