Provider Demographics
NPI:1487083036
Name:SIMMONS, CARA
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:SIMMONS
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 1:4940 HAVERHILL COMMONS CIR
Mailing Address - Street 2:APT 26
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-6003
Mailing Address - Country:US
Mailing Address - Phone:305-926-1615
Mailing Address - Fax:
Practice Address - Street 1:4940 HAVERHILL COMMONS CIR
Practice Address - Street 2:APT 26
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-6003
Practice Address - Country:US
Practice Address - Phone:305-926-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health