MEDICARE: EVAN HOME CARE SERVICES

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	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1558051441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVAN HOME CARE SERVICES

Provider Business Mailing Address
First Line	:	4606 YELLOW BAY DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34758-2505
Country	:	US
Telephone Number	:	321-300-9077
Fax Number	:	321-291-5124

Provider Business Practice Location Address
First Line	:	4606 YELLOW BAY DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34758-2505
Country	:	US
Telephone Number	:	321-300-9077
Fax Number	:	321-291-5124

Authorized Official
Title or Position	:	OWNER
Name	:	VADIA ESTEVEZ
Credential	:
Telephone Number	:	321-300-9077

Provider Enumeration Date	:	05/12/2023
Last Update Date	:	05/12/2023

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