| Evara Therapeutics, Inc. | |
|
26286 Us Highway 19 N Ste B Clearwater FL 33761-4506 | |
| (727) 824-8100 | |
| Not Available |
| Full Name | Evara Therapeutics, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 26286 Us Highway 19 N Ste B, Clearwater, Florida |
| Authorized Official Name and Position | Elodie Dorso (PRESIDENT/CEO) |
| Authorized Official Contact | 7278248100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evara Therapeutics, Inc. 14100 58th St N Clearwater FL 33760-9900 Ph: (727) 824-8181 | Evara Therapeutics, Inc. 26286 Us Highway 19 N Ste B Clearwater FL 33761-4506 Ph: (727) 824-8100 |
| NPI Number | 1619777877 |
|---|---|
| Provider Enumeration Date | 03/17/2025 |
| Last Update Date | 04/02/2025 |
| Certification Date | 04/02/2025 |
| Medicare PECOS PAC ID | 2961909411 |
|---|---|
| Medicare Enrollment ID | O20251009002381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619777877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Lindsay Suzanne Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972706141 PECOS PAC ID: 8022267236 Enrollment ID: I20121003000711 |
| Provider Name | Katina M Bonaparte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174770150 PECOS PAC ID: 0345421913 Enrollment ID: I20121119000425 |
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