Healthcare Provider Details
I. General information
NPI: 1750249595
Provider Name (Legal Business Name): EVOLVED BEHAVIORAL HEALTH OF FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/12/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1375 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85257-3429
US
IV. Provider business mailing address
1375 N SCOTTSDALE RD STE 200
SCOTTSDALE AZ
85257-3429
US
V. Phone/Fax
- Phone: 480-877-9284
- Fax:
- Phone: 480-877-9284
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TRISTAN
GORRINDO
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 480-877-9284