Provider Demographics
NPI:1073632436
Name:VILSAINT, EVENS
Entity Type:Individual
Prefix:MR
First Name:EVENS
Middle Name:
Last Name:VILSAINT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 S KIRKMAN RD APT 1623
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-2322
Mailing Address - Country:US
Mailing Address - Phone:407-253-0333
Mailing Address - Fax:
Practice Address - Street 1:6903 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6829
Practice Address - Country:US
Practice Address - Phone:407-253-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation