Provider Demographics
NPI:1982670352
Name:EVANS, LISA J (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:J
Last Name:EVANS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7100 W CAMINO REAL
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5510
Mailing Address - Country:US
Mailing Address - Phone:561-391-2770
Mailing Address - Fax:561-391-2930
Practice Address - Street 1:7100 W CAMINO REAL
Practice Address - Street 2:SUITE 207
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5510
Practice Address - Country:US
Practice Address - Phone:561-391-2770
Practice Address - Fax:561-391-2930
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2013-11-20
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Provider Licenses
StateLicense IDTaxonomies
FLME43358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine