| Evencare LLC | |
|
128 Orange Ave Ste 238 Daytona Beach FL 32114-4310 | |
| (386) 872-8534 | |
| (386) 204-7309 |
| Full Name | Evencare LLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 128 Orange Ave Ste 238, Daytona Beach, Florida |
| Authorized Official Name and Position | Abisoye Somorin (APRN) |
| Authorized Official Contact | 3868728534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evencare LLC 128 Orange Ave Ste 238 Daytona Beach FL 32114-4310 Ph: (386) 872-8534 | Evencare LLC 128 Orange Ave Ste 238 Daytona Beach FL 32114-4310 Ph: (386) 872-8534 |
| NPI Number | 1801550140 |
|---|---|
| Provider Enumeration Date | 10/22/2021 |
| Last Update Date | 03/27/2024 |
| Certification Date | 03/27/2024 |
| Medicare PECOS PAC ID | 4688018914 |
|---|---|
| Medicare Enrollment ID | O20240214004205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801550140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | () | Primary |
| Provider Name | Abisoye Somorin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689026924 PECOS PAC ID: 5193012631 Enrollment ID: I20160927000858 |
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