Evans, Jason Anthony

Evans, Jason Anthony is an sole proprietor health care provider with primary practice located at 2800 E Commercial Blvd Suite 207, Fort Lauderdale FL 33308-4229. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Evans, Jason Anthony can be contacted via phone (954) 776-5700.

Contact Information

Primary practice address
2800 E Commercial Blvd Suite 207 Fort Lauderdale FL 33308-4229
Phone: (954) 776-5700
Fax: (954) 776-5701
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO2835 Florida

Profile Details

NPI number 1093704306
LBN Legal business name Evans, Jason Anthony
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2005
Last updated May 21st, 2016 - about 10 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 1093704306 NPPES
Florida MEDICAID 340316500

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