Evans, Tammy L

Evans, Tammy L is an sole proprietor health care provider with primary practice located at 5150 Fountains Dr S , Lake Worth FL 33467-5715. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Evans, Tammy L can be contacted via phone (843) 455-2415.

Contact Information

Primary practice address
5150 Fountains Dr S Lake Worth FL 33467-5715
Phone: (843) 455-2415
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 3841 South Carolina
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 37908 Florida

Profile Details

NPI number 1336202498
LBN Legal business name Evans, Tammy L
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2006
Last updated Jun 22nd, 2023 - 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 1336202498 NPPES
Florida MEDICAID 112495700
Florida MEDICAID TH1333

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