Provider Demographics
NPI:1538166590
Name:EVANS, RORY A (MD)
Entity type:Individual
Prefix:MR
First Name:RORY
Middle Name:A
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W GORE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1035
Mailing Address - Country:US
Mailing Address - Phone:407-841-7724
Mailing Address - Fax:407-841-9825
Practice Address - Street 1:200 W GORE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1035
Practice Address - Country:US
Practice Address - Phone:407-841-7724
Practice Address - Fax:407-841-9825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34052207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C48295Medicare UPIN
48993Medicare ID - Type Unspecified