Provider Demographics
NPI:1871513408
Name:SIMONS, VICTOR M (MD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:M
Last Name:SIMONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4469
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-4469
Mailing Address - Country:US
Mailing Address - Phone:787-876-5000
Mailing Address - Fax:787-876-2422
Practice Address - Street 1:CALLE CORCHADO FINAL
Practice Address - Street 2:1616
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-5000
Practice Address - Fax:787-876-2422
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR14469208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH98598Medicare UPIN
PR0021878Medicare PIN