Individual
THEODORE ALFRED EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
925 NE 30TH TER, SUITE 102, HOMESTEAD, FL 33033
(305) 247-1701
(305) 247-1799
Mailing address
925 NE 30TH TER, SUITE 102, HOMESTEAD, FL 33033-7613
(305) 247-1701
(305) 247-1799
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME47564
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08743
BCBS
—
01
—
1003510
PHP
—
01
—
12255
WELL CARE
—
01
—
13451
ALL FLORIDA
—
01
—
1942206701
MD MEDICARE CHOICE
—
01
—
200010270
RAILROAD MEDICARE
—
05
—
250454500
—
FL
01
—
273479
ONE HEALTH
FL
01
—
54115
JMH
FL
01
—
592417574001
CHAMPUS/TRICARE
—
01
—
7574
AV MED
—
01
—
9319
FOUNDATION
—
Enumeration date
06/24/2005
Last updated
06/27/2018
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