| NPI | 1003273947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS JAY EVANS Owner Manager 561-213-9373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9102141) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP3280102) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |