Individual
DWELVIN L SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2161 KINGSLEY AVE, SUITE 100, ORANGE PARK, FL 32073-5116
(904) 276-2303
(904) 276-9690
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME77936
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1099111
WELLCARE
FL
01
—
1115826
CARE PLUS
FL
01
—
1254570
STAYWELL (MEDICAID) AND WELLCARE (MEDICARE).
FL
05
—
256841100
—
FL
01
—
258515
AVMED
FL
01
—
68967
BCBS
FL
01
—
7638449
CIGNA
FL
01
—
7884043
AETNA
FL
01
—
P00202470
MEDICARE RAILROAD
FL
01
—
P01451925
RR MEDICARE
FL
01
—
P01596543
RR MEDICARE
FL
Enumeration date
04/27/2006
Last updated
02/01/2017
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