Healthcare Provider Details

I. General information

NPI: 1811769912
Provider Name (Legal Business Name): EVELYN SARO GIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 WORLD PLAZA LN BLDG 51
FORT MYERS FL
33907-3991
US

IV. Provider business mailing address

12501 WORLD PLAZA LN BLDG 51
FORT MYERS FL
33907-3991
US

V. Phone/Fax

Practice location:
  • Phone: 239-349-3139
  • Fax:
Mailing address:
  • Phone: 239-349-3139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: