Individual provider Active NPI

Ricardo Simeon, MD

  • Pain Medicine (Anesthesiology) Physician
  • Lakeland, FL
National Provider Identifier
1689788994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
ME64764 Issued in FL
Practice address
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone
(352) 867-8898
Fax
(352) 732-6282
NPI assigned
Aug 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X ME64764 FL Primary

Addresses

Primary practice location

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543

Mailing address

PO Box 106002
Atlanta, GA 30348-6002
Phone (352) 867-8898

Other identifiers 1

IdentifierTypeStateIssuer
49594OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME64764FLMDPain Medicine (Anesthesiology) Physician
09566RLAMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689788994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 106002",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303486002",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEON",
        "first_name": "RICARDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME64764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "49594",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.