Provider Demographics
NPI:1932374071
Name:SIMPSON, STANLEY L (DO)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:L
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:415 SE 11TH TER
Mailing Address - Street 2:UNIT 301
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4526
Mailing Address - Country:US
Mailing Address - Phone:305-935-6457
Mailing Address - Fax:208-379-6886
Practice Address - Street 1:415 SE 11TH TER
Practice Address - Street 2:UNIT 301
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-4526
Practice Address - Country:US
Practice Address - Phone:305-935-6457
Practice Address - Fax:208-379-6886
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2015-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS6528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF53006Medicare UPIN