Basic Information
| Provider Information | |||||||||
| NPI: | 1861458168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMMONS | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | DEAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7200 CORPORATE CENTER DR | ||||||||
| Address2: | #600 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331261200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055002000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5643 NW 29TH ST | ||||||||
| Address2: | |||||||||
| City: | MARGATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330631531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549796900 | ||||||||
| FaxNumber: | 9549702561 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 08/19/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | ME 61682 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | ME61692 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | 379930100 | 05 | FL | MEDICAID | 18107C | 01 | FL | MEDICARE AVENTURA | OTHER | 18107R | 01 | FL | MEDICARE NORTH MIAMI | OTHER | 18107D | 01 | FL | MEDICARE PEMBROKE | OTHER | 18107K | 01 | FL | MEDICARE BISCAYNE | OTHER |