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General NPI Number Information
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NPI Number | 1649164864
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Entity Type | Organization
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Legal Business Name | EVLYN EICKHOFF, M.D., PLLC.
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 12515 ORANGE DR STE 804
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City | DAVIE
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State | FL
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Zip | 33330-4309
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Country | US
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Telephone | 505-392-1500
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Fax | 844-670-3932
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Provider Business Mailing Address
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Address Line | 11300 NW 22ND ST
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City | PLANTATION
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State | FL
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Zip | 33323-2023
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Country | US
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Telephone | 505-392-1500
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Fax | 844-670-3932
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Authorized Official
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Title or Position | MANAGER/ OWNER
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Name | EVLYN EICKHOFF
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Credential | MD
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Telephone | 505-392-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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