Provider Demographics
NPI:1689904575
Name:AARON J. EVANS O.D. P.A.
Entity Type:Organization
Organization Name:AARON J. EVANS O.D. P.A.
Other - Org Name:VISUAL EYES AT MIZNER PARK
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-392-8383
Mailing Address - Street 1:333 PLAZA REAL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3938
Mailing Address - Country:US
Mailing Address - Phone:561-392-8383
Mailing Address - Fax:561-392-1134
Practice Address - Street 1:333 PLAZA REAL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3938
Practice Address - Country:US
Practice Address - Phone:561-392-8383
Practice Address - Fax:561-392-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4314152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty