Provider Demographics
NPI:1285152595
Name:PAVLOVA, EVELINA
Entity type:Individual
Prefix:
First Name:EVELINA
Middle Name:
Last Name:PAVLOVA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 SIMPSON RD # 1141
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4604
Mailing Address - Country:US
Mailing Address - Phone:407-603-6488
Mailing Address - Fax:
Practice Address - Street 1:1431 SIMPSON RD # 1141
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4604
Practice Address - Country:US
Practice Address - Phone:407-603-6488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health