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NPI Code Detail

MEDICARE: RAYMOND M. EVANS III M.D.

MEDICARE:   RAYMOND M. EVANS III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianME102748FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1145J7OTHERFLBLUECROSS BLUESHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134234099
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND M. EVANS III M.D.
Provider Business Mailing Address
First Line : PO BOX 198441
Second Line :
City : ATLANTA
State : GA
Zip : 30384-8441
Country : US
Telephone Number : 813-745-4673
Fax Number :
Provider Business Practice Location Address
First Line : 12902 USF MAGNOLIA DR
Second Line :
City : TAMPA
State : FL
Zip : 33612-9416
Country : US
Telephone Number : 813-745-4673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 03/13/2026

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