Healthcare Provider Details

I. General information

NPI: 1841476959
Provider Name (Legal Business Name): DR EVELYN M CLOUD P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8211 MAR DEL PLATA ST E
JACKSONVILLE FL
32256-7349
US

IV. Provider business mailing address

8211 MAR DEL PLATA ST E
JACKSONVILLE FL
32256-7349
US

V. Phone/Fax

Practice location:
  • Phone: 904-388-4561
  • Fax: 904-620-9748
Mailing address:
  • Phone: 904-534-3316
  • Fax: 904-620-9748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPO1367
License Number StateFL

VIII. Authorized Official

Name: DR. EVELYN M CLOUD
Title or Position: DOCTOR OF PODIATRIC MEDICINE
Credential: DPM
Phone: 904-534-3316