NPI | 1194282756 |
---|---|
Doing Business As | EVARA HEALTH AT COUNTRYSIDE |
Entity Type | Organization |
Authorized Contact | EDWARD KUCHER Chief Regulatory Officer 727-824-8100 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 208D00000X General Practice |
261QM1300X Clinic/Center, Multi-Specialty | |
Enumeration Date | 2019-03-01 |
Last Update Date | 2024-12-24 |