Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY8180 | FL |
Y | 103TC0700X | Clinical Psychologist | PY8180 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PY8180 | FL |
NPI | 1225339336 |
---|---|
Provider Name | Dr. Milagros Evardone |
First Address | Tampa, FL 33612-4745 |
Second Address | Tampa, FL 33612-4745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2010 |
Last Update Date | 12/11/2013 |