Individual
MATTHEW SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
5020 WALTON AVE, TITUSVILLE, FL 32780-6826
(321) 268-9510
Mailing address
5020 WALTON AVE, TITUSVILLE, FL 32780-6826
(321) 268-9510
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11849
FL
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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