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Contact Information

EVAN M INCINELLI
1600 SW ARCHER RD
GAINESVILLE, FL32610
 Phone: 352-265-0111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for EVAN M INCINELLI · (Male)

NPI # 1528623238
Status Active
Credentials
Entity Individual
Enumeration date 05/08/2019
Last updated 01/24/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # PA9112310
  • FL Medicaid 104303800
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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