| Evans Family Care Pa | |
|
5026 Silver Star Rd Orlando FL 32808-4545 | |
| (407) 532-4615 | |
| (407) 532-4686 |
| Full Name | Evans Family Care Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 5026 Silver Star Rd, Orlando, Florida |
| Authorized Official Name and Position | Loc Kim Le (PRESIDENT) |
| Authorized Official Contact | 4075324615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evans Family Care Pa 5026 Silver Star Rd Orlando FL 32808-4545 Ph: (407) 532-4615 | Evans Family Care Pa 5026 Silver Star Rd Orlando FL 32808-4545 Ph: (407) 532-4615 |
| NPI Number | 1548452600 |
|---|---|
| Provider Enumeration Date | 08/13/2007 |
| Last Update Date | 10/04/2007 |
| Medicare PECOS PAC ID | 5890881395 |
|---|---|
| Medicare Enrollment ID | O20071015000181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548452600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Loc Kim Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316164205 PECOS PAC ID: 1153412226 Enrollment ID: I20070802000648 |
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