Provider Demographics
NPI:1457935835
Name:JEAN-SIMON, TRICY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRICY
Middle Name:
Last Name:JEAN-SIMON
Suffix:
Gender:F
Credentials:PHARMD
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 221036
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33022-1036
Mailing Address - Country:US
Mailing Address - Phone:305-491-8074
Mailing Address - Fax:
Practice Address - Street 1:1700 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2947
Practice Address - Country:US
Practice Address - Phone:954-462-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy