| Organization Name: | SL EVANS LLC |
| NPI Number: | 1003273947 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUCAS JAY EVANS (OWNER MANAGER) |
| Mailing Address: | 32 Country Lake Cir Boynton Beach |
| State: | FL US |
| Postal Code: | 334366200 |
| Phone Number: | 5612139373 |
| Fax Number: | 5614232688 |
| NPI Enumeration Date: | 01/22/2016 |
| NPI Last Update Date: | 01/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | ARNP3280102 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |