Individual
DR. FRED L SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4665 S CONGRESS AVE, SUITE 100, LAKE WORTH, FL 33461-4754
(561) 649-0243
(561) 649-4132
Mailing address
PO BOX 20689, WEST PALM BEACH, FL 33416-0689
(561) 649-0243
(561) 649-0243
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME 30854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000594200
—
FL
05
—
038426700
—
FL
01
—
P00686507
RAILROAD MEDICARE
FL
Enumeration date
09/21/2005
Last updated
05/15/2009
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