Fred L Simon MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME30854 Issued in FL

Legal business name

FRED L SIMON MD PA

Practice address

4665 S Congress Ave
Suite 102
Lake Worth, FL 33461-4754

Phone

(561) 649-0243

Fax

(561) 649-4132

NPI assigned

Sep 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Fred L Simon, MD, FRCS(C) FACSNPI 1437145919

Title

President

Phone

(561) 642-0243

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fred L Simon, MD

  • Surgery Physician
  • Lake Worth, FL
  • NPI 1437145919
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200873600000",
    "number": "1003001488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20689",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334160689",
            "telephone_number": "561-642-0243",
            "fax_number": "561-649-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 S CONGRESS AVE",
            "address_2": "SUITE 102",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614754",
            "telephone_number": "561-649-0243",
            "fax_number": "561-649-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED L SIMON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2008-01-21",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-642-0243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FRCS(C) FACS"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME30854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.