MEDICARE: TAINA MELISSA EVEILLARD

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1447085451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAINA MELISSA EVEILLARD

Provider Business Mailing Address
First Line	:	15999 SW 8TH AVE APT A202
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33444-2184
Country	:	US
Telephone Number	:	786-376-2801
Fax Number	:

Provider Business Practice Location Address
First Line	:	15999 SW 8TH AVE APT A202
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33444-2184
Country	:	US
Telephone Number	:	786-376-2801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	12/04/2025

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Directions to “ TAINA MELISSA EVEILLARD ” Practice Location

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