Provider Demographics
NPI:1902860281
Name:CLOUD, EVELYN M (DPM)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:M
Last Name:CLOUD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8211 MAR DEL PLATA ST E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7349
Mailing Address - Country:US
Mailing Address - Phone:904-388-4561
Mailing Address - Fax:904-620-9748
Practice Address - Street 1:8211 MAR DEL PLATA ST E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7349
Practice Address - Country:US
Practice Address - Phone:904-388-4561
Practice Address - Fax:904-620-9748
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1367213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480001452OtherMEDICARE RAILROAD
FL041331300Medicaid
FL041331300Medicaid
FL480001452OtherMEDICARE RAILROAD