Healthcare Provider Details

I. General information

NPI: 1649450826
Provider Name (Legal Business Name): ROBERT GORDON EVANS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 11/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 W NEWBERRY RD
GAINESVILLE FL
32605-4309
US

IV. Provider business mailing address

6500 W NEWBERRY RD
GAINESVILLE FL
32605-4309
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-4900
  • Fax:
Mailing address:
  • Phone: 352-333-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP0823580
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 9180714
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 174576
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 558976
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 32633
License Number StateNV
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 0001 157439
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: