Long, Evonne Marie

Long, Evonne Marie is an individual health care provider with primary practice located at 1010 N Davis St Ste 101 , Jacksonville FL 32209. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Long, Evonne Marie can be contacted via phone (904) 355-3403.

Contact Information

Primary practice address
1010 N Davis St Ste 101 Jacksonville FL 32209
Phone: (904) 355-3403
Fax: (904) 355-4149
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 7987 South Carolina
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AY1974 Florida

Profile Details

NPI number 1124497987
LBN Legal business name Long, Evonne Marie
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2015
Last updated Oct 18th, 2024 - about 2 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 1124497987 NPPES
Florida MEDICAID 019346100
Florida Other AY1974

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