Organization
E & M MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOELLE M INNOCENT-SIMON D.O. (MEDICAL DOCTOR)
(352) 468-1735
Entity
Organization
Contact information
Practice address
10383 HAMPTON AVE, STARKE, FL 32091-7843
(352) 468-1735
(352) 468-1739
Mailing address
10383 HAMPTON AVE, STARKE, FL 32091-7843
(352) 468-1735
(352) 468-1739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS0006902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250170800
—
FL
01
—
57355
BCBS
FL
Enumeration date
01/24/2006
Last updated
03/22/2011
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