Provider Demographics
NPI:1558326678
Name:SINCLAIR, EVELYN HELENE (MD)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:HELENE
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:H
Other - Last Name:SINCLAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4720 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5808
Mailing Address - Country:US
Mailing Address - Phone:954-989-3719
Mailing Address - Fax:
Practice Address - Street 1:4720 PIERCE ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5808
Practice Address - Country:US
Practice Address - Phone:954-989-3719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33402207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE14551Medicare UPIN
FL93737Medicare ID - Type Unspecified