Evans, Paul

Evans, Paul is an individual health care provider with primary practice located at 4450 W Eau Gallie Blvd 200, Melbourne FL 32934-7213. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Pastoral. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Evans, Paul can be contacted via phone (321) 752-3100.

Contact Information

Primary practice address
4450 W Eau Gallie Blvd 200 Melbourne FL 32934-7213
Phone: (321) 752-3100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X LCMFT0241021200 Florida
Behavioral Health & Social Service Providers / Pastoral 101YP1600X LCMFT0241021200 Florida

Profile Details

NPI number 1346371077
LBN Legal business name Evans, Paul
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2007
Last updated Jan 15th, 2016 - about 9 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 1346371077 NPPES
Florida MEDICAID 768243300
Florida MEDICAID 076542200

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