SL Evans LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9102141 Issued in FL

Legal business name

SL EVANS LLC

Practice address

32 Country Lake Cir
Boynton Beach, FL 33436-6200

Phone

(561) 213-9373

Fax

(561) 423-2688

NPI assigned

Jan 22, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lucas Jay Evans, PA-C

Title

Owner Manager

Phone

(561) 213-9373

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1003273947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 COUNTRY LAKE CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334366200",
            "telephone_number": "561-213-9373",
            "fax_number": "561-423-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 COUNTRY LAKE CIR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334366200",
            "telephone_number": "561-213-9373",
            "fax_number": "561-423-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SL EVANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "561-213-9373",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9102141",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP3280102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.