Individual
MISS TANDRA LAMIKIA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
901 NW 8TH AVE STE A2, GAINESVILLE, FL 32601-5000
(352) 258-3450
(352) 379-5502
Mailing address
PO BOX 358774, GAINESVILLE, FL 32635-8774
(352) 258-3450
(352) 373-7818
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
689678296
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689678296
—
FL
05
—
80-0388997
—
FL
Enumeration date
06/07/2013
Last updated
10/24/2022
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