Provider Demographics
NPI:1538772546
Name:SIMO, MARYANN A (PHARMD)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:A
Last Name:SIMO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MARYANN
Other - Middle Name:M
Other - Last Name:ABDELMASIH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:15295 COLLIER BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7715
Mailing Address - Country:US
Mailing Address - Phone:239-352-7354
Mailing Address - Fax:239-352-8341
Practice Address - Street 1:15295 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-7715
Practice Address - Country:US
Practice Address - Phone:239-352-7354
Practice Address - Fax:239-352-8341
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist