Salvador Miguel Simo, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0044968 Issued in FL

Practice address

1497 Forest Hill Blvd Ste E
Lake Clarke Shores, FL 33406-6052

Phone

(561) 433-5687

NPI assigned

Apr 10, 2006

Last updated

Jul 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Miguel Simo Other name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Simo and Bruck Pediatrics,LLC

  • Pediatric Adolescent Medicine Physician
  • Wellington, FL
  • NPI 1093931651
  NPD

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1962465054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12008 SOUTHSHORE BLVD.",
            "address_2": "STE. 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148502",
            "telephone_number": "561-429-3812",
            "fax_number": "561-429-3891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FOREST HILL BLVD STE E",
            "city": "LAKE CLARKE SHORES",
            "state": "FL",
            "postal_code": "334066052",
            "telephone_number": "561-433-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMO",
        "first_name": "SALVADOR",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "0044968",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "0044968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043524400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIGUEL",
            "last_name": "SIMO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lorena Rodriguez Rodriguez
• Linnette Santos Robles, M. ED., LMHC
• Kristy Senecal
• SHP Investments, LLC (Concepts in Eldercare)
• Alejandro Jesus Silva Rodriguez
• St. Anne Medical Center Inc.
• Denice Suarez Machin, RBT
• Jennifer Wysong
• Camilo Antonio Young I

• Pediatrics Physician in Lake Clarke Shores, FL
• Providers in Lake Clarke Shores, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.