Provider Demographics
NPI:1447906797
Name:PERES CARNEIRO SUNDQUIST, SIMONE (MD)
Entity type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:
Last Name:PERES CARNEIRO SUNDQUIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 W FREDERICK SMALL RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8704
Mailing Address - Country:US
Mailing Address - Phone:786-427-5119
Mailing Address - Fax:
Practice Address - Street 1:3375 BURNS RD STE 108
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4360
Practice Address - Country:US
Practice Address - Phone:561-899-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34093225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist