Provider Demographics
NPI:1093082802
Name:ADIKES, EVELYN JANE (OTR)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:JANE
Last Name:ADIKES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 BEACH TRL
Mailing Address - Street 2:B
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-2949
Mailing Address - Country:US
Mailing Address - Phone:914-497-3553
Mailing Address - Fax:855-497-3553
Practice Address - Street 1:2004 BEACH TRL
Practice Address - Street 2:B
Practice Address - City:INDIAN ROCKS BEACH
Practice Address - State:FL
Practice Address - Zip Code:33785-2949
Practice Address - Country:US
Practice Address - Phone:914-497-3553
Practice Address - Fax:855-497-3553
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14191225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist