Healthcare Provider Details

I. General information

NPI: 1558326678
Provider Name (Legal Business Name): EVELYN HELENE SINCLAIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EVELYN H. SINCLAIR M.D.

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 PIERCE ST
HOLLYWOOD FL
33021-5808
US

IV. Provider business mailing address

4720 PIERCE ST
HOLLYWOOD FL
33021-5808
US

V. Phone/Fax

Practice location:
  • Phone: 954-989-3719
  • Fax:
Mailing address:
  • Phone: 954-989-3719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number33402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: