Provider Demographics
NPI:1780657262
Name:PAPAGEORGE, EVANGELIA (MD)
Entity type:Individual
Prefix:
First Name:EVANGELIA
Middle Name:
Last Name:PAPAGEORGE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:725-220-8457
Mailing Address - Fax:833-749-0355
Practice Address - Street 1:3129 N RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4578
Practice Address - Country:US
Practice Address - Phone:725-220-8457
Practice Address - Fax:833-749-0355
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1780657262Medicaid
NV11305OtherSTATE LICENSE
NV100505758Medicaid
NV100505758Medicaid
NVV100430Medicare PIN
NV100430Medicare PIN
H95887Medicare UPIN