Individual
DR. KENNETH M SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4255 BOY SCOUT CAMP, NEW SMYRNA BEACH, FL 32168-8896
(386) 478-1977
Mailing address
4255 BOY SCOUT ROAD, NEW SMYRNA BEACH, FL 32168
(386) 478-1977
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
OS7658
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254951400
—
FL
Enumeration date
10/14/2005
Last updated
08/25/2010
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