Individual
MR. MICHEL EVANS DORVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 NE 125TH ST, NORTH MIAMI, FL 33161-5936
(305) 685-5688
(305) 891-5515
Mailing address
1200 NE 125TH ST, NORTH MIAMI, FL 33161-5936
(305) 685-5688
(305) 891-5515
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 9101758
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009220100
—
FL
Enumeration date
10/19/2005
Last updated
04/08/2020
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