Provider Demographics
NPI:1164754925
Name:VILLAR, EVELYN GLENNYS (ARNP)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:GLENNYS
Last Name:VILLAR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:GLENNYS
Other - Last Name:HELSETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4700 MILLENIA BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:407-447-7120
Mailing Address - Fax:
Practice Address - Street 1:360 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3335
Practice Address - Country:US
Practice Address - Phone:407-788-8200
Practice Address - Fax:407-788-3746
Is Sole Proprietor?:No
Enumeration Date:2010-02-04
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9259806208100000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002942600Medicaid