Organization
SL EVANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUCAS JAY EVANS PA-C (OWNER MANAGER)
(561) 213-9373
Entity
Organization
Contact information
Practice address
32 COUNTRY LAKE CIR, BOYNTON BEACH, FL 33436-6200
(561) 213-9373
(561) 423-2688
Mailing address
32 COUNTRY LAKE CIR, BOYNTON BEACH, FL 33436-6200
(561) 213-9373
(561) 423-2688
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102141
FL
363LA2100X
Acute Care Nurse Practitioner
ARNP3280102
FL
Other
Enumeration date
01/22/2016
Last updated
01/22/2016
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