Provider Demographics
NPI:1225479983
Name:EVANS, RACHAEL C (DO)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:C
Last Name:EVANS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6017
Mailing Address - Fax:904-450-6041
Practice Address - Street 1:3200 3RD ST S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-6096
Practice Address - Country:US
Practice Address - Phone:904-450-7050
Practice Address - Fax:904-450-7059
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO3605208000000X
MN60736208000000X
FLOS16064208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics