MEDICARE: JUSTIN EVANS

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	367H00000X	Anesthesiologist Assistant	AA1140	FL

General Provider Information

NPI Number	:	1598643819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN EVANS

Provider Business Mailing Address
First Line	:	244 CONSERVATION DR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-2472
Country	:	US
Telephone Number	:	954-548-1837
Fax Number	:

Provider Business Practice Location Address
First Line	:	17000 PORTER RD
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-8800
Country	:	US
Telephone Number	:	407-407-0000
Fax Number	:

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

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	02/24/2026

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Directions to “ JUSTIN EVANS ” Practice Location

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