Simon, Jacqueline Deborah

Simon, Jacqueline Deborah is an individual health care provider with primary practice located at 7789 Nw Beacon Square Blvd , Boca Raton FL 33487-1326. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Simon, Jacqueline Deborah can be contacted via phone (561) 241-7977.

Contact Information

Primary practice address
7789 Nw Beacon Square Blvd Boca Raton FL 33487-1326
Phone: (561) 241-7977
Fax: (561) 405-2087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X APRN9328821 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN9328821 Florida

Profile Details

NPI number 1497200307
LBN Legal business name Simon, Jacqueline Deborah
Credentials APRN, PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2016
Last updated Jul 16th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497200307 NPPES
Florida MEDICAID 101264100

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