Provider Demographics
NPI:1316986748
Name:SIMION-RODGERS, SORINA
Entity type:Individual
Prefix:
First Name:SORINA
Middle Name:
Last Name:SIMION-RODGERS
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 1:6843 EDGEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5141
Mailing Address - Country:US
Mailing Address - Phone:303-990-1208
Mailing Address - Fax:720-836-3312
Practice Address - Street 1:6843 EDGEWOOD PL
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5141
Practice Address - Country:US
Practice Address - Phone:303-990-1208
Practice Address - Fax:720-836-3312
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO450552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO81880804Medicaid
COCOA108755Medicare PIN