MEDICARE: MR. MORRIS C EVANS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA 9102232	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003839531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MORRIS C EVANS PA-C

Provider Business Mailing Address
First Line	:	5881 TURKEY LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7747
Country	:	US
Telephone Number	:	407-224-2273
Fax Number	:	407-264-6494

Provider Business Practice Location Address
First Line	:	5881 TURKEY LAKE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7747
Country	:	US
Telephone Number	:	407-224-2273
Fax Number	:	407-264-6494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	10/16/2024

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