Individual
SHIRLEY SIMEONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 N MOON AVE, BRANDON, FL 33510-4419
(813) 689-8828
Mailing address
135 N MOON AVE, BRANDON, FL 33510-4419
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767124500
—
FL
Enumeration date
02/15/2007
Last updated
07/08/2007
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