Individual
DR. ANDREW ROBERT SIMONSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-3288
(727) 456-3289
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, SUITE 108, ST PETERSBURG, FL 33701-1547
(727) 456-3288
(727) 456-3289
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
OS 11689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006311700
—
FL
01
—
14LY7
BLUE CROSS
FL
Enumeration date
10/11/2007
Last updated
06/24/2014
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