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Individual

EVANGELA DILLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10800 BRIGHTON BAY BLVD NE APT 7308, SAINT PETERSBURG, FL 33716-3496
(727) 564-7769
(727) 800-5144
Mailing address
10800 BRIGHTON BAY BLVD NE APT 7308, SAINT PETERSBURG, FL 33716-3496
(727) 564-7769
(727) 800-5144

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
17438
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
80-0871218
FL
Enumeration date
12/21/2017
Last updated
12/21/2017
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