Provider Demographics
NPI:1871135269
Name:SIMS, TEVONSHEYE
Entity type:Individual
Prefix:
First Name:TEVONSHEYE
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 KISMET AVE
Mailing Address - Street 2:
Mailing Address - City:PAHOKEE
Mailing Address - State:FL
Mailing Address - Zip Code:33476-1317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:327 KISMET AVE
Practice Address - Street 2:
Practice Address - City:PAHOKEE
Practice Address - State:FL
Practice Address - Zip Code:33476-1317
Practice Address - Country:US
Practice Address - Phone:561-480-2093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator