Provider Demographics
NPI:1396708376
Name:SIMS, REBECCA JOY (OD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JOY
Last Name:SIMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:JOY
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:501 N HOWARD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1213
Mailing Address - Country:US
Mailing Address - Phone:727-581-8706
Mailing Address - Fax:727-588-2447
Practice Address - Street 1:501 N HOWARD AVE STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1213
Practice Address - Country:US
Practice Address - Phone:727-581-8706
Practice Address - Fax:727-588-2447
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0PC3618152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20995OtherBLUE CROSS
FL620696400Medicaid
FL20995BMedicare ID - Type Unspecified
FL20995OtherBLUE CROSS