Organization
EVANS EYE CARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON EVANS OD (OPTOMETRIST)
(302) 670-4096
Entity
Organization
Contact information
Practice address
1711 NE 163RD ST, NORTH MIAMI BEACH, FL 33162-4732
(302) 670-4096
(305) 949-7301
Mailing address
235 NW 207TH TER, PEMBROKE PINES, FL 33029-3506
(302) 670-4096
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014059500
—
FL
Enumeration date
09/18/2018
Last updated
10/24/2018
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