Healthcare Provider Details

I. General information

NPI: 1003709189
Provider Name (Legal Business Name): EVELYN DE LA C PARDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 FOREST HILL BLVD STE 103
WEST PALM BEACH FL
33406-5854
US

IV. Provider business mailing address

3195 W 72ND TER
HIALEAH FL
33018-5224
US

V. Phone/Fax

Practice location:
  • Phone: 561-964-4577
  • Fax: 561-964-4572
Mailing address:
  • Phone: 786-286-7667
  • Fax: 786-286-7667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11039815
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: