Simon, Kenneth M

Simon, Kenneth M is an sole proprietor health care provider with primary practice located at 4255 Boy Scout Camp , New Smyrna Beach FL 32168-8896. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Simon, Kenneth M can be contacted via phone (386) 478-1977.

Contact Information

Primary practice address
4255 Boy Scout Camp New Smyrna Beach FL 32168-8896
Phone: (386) 478-1977
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X OS7658 Florida

Profile Details

NPI number 1073502993
LBN Legal business name Simon, Kenneth M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 14th, 2005
Last updated Aug 25th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073502993 NPPES
Florida MEDICAID 254951400

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