Evans, Blake Joseph

Evans, Blake Joseph is an individual health care provider with primary practice located at 1725 N University Dr Ste 400 , Coral Springs FL 33071-6053. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Evans, Blake Joseph can be contacted via phone (954) 752-3166.

Contact Information

Primary practice address
1725 N University Dr Ste 400 Coral Springs FL 33071-6053
Phone: (954) 752-3166
Fax: (954) 753-5628
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X ME117404 Florida

Profile Details

NPI number 1093971467
LBN Legal business name Evans, Blake Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2008
Last updated Sep 16th, 2022 - about 3 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 1093971467 NPPES
Florida Other 368241 AVMED
Florida Other P1011066 AVMED
Florida MEDICAID 009591500 AVMED
Florida Other P01230859 AVMED
Florida Other 7735843 AVMED
Florida Other 1193019 AVMED
Florida Other 14RS8 AVMED
Florida Other 4955788 AVMED

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