Provider Demographics
NPI:1568675445
Name:SANGIOVANNI, EVELYN C (MS)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:C
Last Name:SANGIOVANNI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10874 SW 152ND PLACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196
Mailing Address - Country:US
Mailing Address - Phone:305-387-4268
Mailing Address - Fax:305-387-4268
Practice Address - Street 1:9380 SW 72 ST. SUITE B-120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5454
Practice Address - Country:US
Practice Address - Phone:305-274-3172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2483Medicaid