Provider Demographics
NPI:1881083020
Name:ARNOLD JAY SIMON, M.D.
Entity type:Organization
Organization Name:ARNOLD JAY SIMON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-641-7486
Mailing Address - Street 1:3175 S CONGRESS AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2562
Mailing Address - Country:US
Mailing Address - Phone:561-641-7486
Mailing Address - Fax:561-641-6196
Practice Address - Street 1:3175 S CONGRESS AVE STE 305
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2562
Practice Address - Country:US
Practice Address - Phone:561-641-7486
Practice Address - Fax:561-641-6196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036884207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty