Individual provider Active NPI

Simon Laine, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1639573157
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP9313024 Issued in FL
Practice address
5010 Hollywood Blvd Ste 100B
Hollywood, FL 33021-6557
Phone
(954) 967-0028
NPI assigned
Oct 13, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X ARNP9313024 FL Primary
Family Nurse Practitioner 363LF0000X ARNP9113024 FL

Addresses

Primary practice location

5010 Hollywood Blvd Ste 100B
Hollywood, FL 33021-6557

Mailing address

5151 Adanson St
Orlando, FL 32804-1317
Phone (407) 875-3700

Other practice location 1

100 Columbia St
Orlando, FL 32806-1006
Phone (407) 875-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230616000591 NM Practitioner - Nurse Practitioner 3678887379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida International Univ, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hidalgo Medical ServicesGroup PAC ID 4587572250, shared by 12 NPIs, 33 clinicians

Practice addresses (Care Compare)

1007 N Pope St
Silver City, NM 88061-5161
Phone (575) 388-1511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9113024FLMDFamily Nurse Practitioner
ARNP9313024FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hidalgo Medical Services Multi-Specialty CurrentSince Jun 2, 2023 Accepting new patients
Broward Community and Family Health Centers Inc Multi-Specialty Current Accepting new patients
Hidalgo Medical Services CurrentSince Jun 2, 2023 Accepting new patients

Locations

5010 Hollywood Blvd
Hollywood, FL 33021

5010 Hollywood Blvd
Ste 100B
Hollywood, FL 33021
Phone (954) 967-0028

5800 W Hallandale Beach Blvd
West Park, FL 33023
Phone (954) 966-3939

530 De Moss St
Lordsburg, NM 88045
Phone (575) 542-2368

1007 N Pope St
Silver City, NM 88061
Phone (575) 388-1511

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639573157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 ADANSON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328041317",
            "telephone_number": "407-875-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 HOLLYWOOD BLVD STE 100B",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216557",
            "telephone_number": "954-967-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Columbia St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061006",
            "country_code": "US",
            "telephone_number": "407-875-3700",
            "fax_number": "407-667-1636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAINE",
        "first_name": "SIMON",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-13",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9313024",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9113024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.