Provider Demographics
NPI:1003839531
Name:EVANS, MORRIS C (PA-C)
Entity type:Individual
Prefix:MR
First Name:MORRIS
Middle Name:C
Last Name:EVANS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5881 TURKEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7747
Mailing Address - Country:US
Mailing Address - Phone:407-224-2273
Mailing Address - Fax:407-264-6494
Practice Address - Street 1:5881 TURKEY LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7747
Practice Address - Country:US
Practice Address - Phone:407-224-2273
Practice Address - Fax:407-264-6494
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9102232363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292604100Medicaid