Provider Demographics
NPI:1144281353
Name:EVANS, DEAN ERNEST (PA-C)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:ERNEST
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 1:5200 N FLAGLER DR
Mailing Address - Street 2:#2303
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2755
Mailing Address - Country:US
Mailing Address - Phone:561-842-0156
Mailing Address - Fax:561-842-0156
Practice Address - Street 1:11924 FOREST HILL BLVD # 10A-243
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6256
Practice Address - Country:US
Practice Address - Phone:561-693-5143
Practice Address - Fax:561-245-9150
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9109897OtherMEDICAL LICENSE