Provider Demographics
NPI:1003709189
Name:PARDO, EVELYN DE LA C
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:DE LA C
Last Name:PARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 W 72ND TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5224
Mailing Address - Country:US
Mailing Address - Phone:786-286-7667
Mailing Address - Fax:786-286-7667
Practice Address - Street 1:3195 W 72ND TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-5224
Practice Address - Country:US
Practice Address - Phone:786-286-7667
Practice Address - Fax:786-286-7667
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039815363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner