Provider Demographics
NPI:1407050701
Name:MEHLMAN, EVAN ADAM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:ADAM
Last Name:MEHLMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2883 EXECUTIVE PARK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3662
Mailing Address - Country:US
Mailing Address - Phone:954-684-6735
Mailing Address - Fax:954-384-1163
Practice Address - Street 1:2883 EXECUTIVE PARK DR STE 102
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3662
Practice Address - Country:US
Practice Address - Phone:954-684-6735
Practice Address - Fax:954-384-1163
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7206103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical