Healthcare Provider Details
I. General information
NPI: 1306643564
Provider Name (Legal Business Name): EVANTI COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14384 SW 97TH TER
MIAMI FL
33186-8857
US
IV. Provider business mailing address
14384 SW 97TH TER
MIAMI FL
33186-8857
US
V. Phone/Fax
- Phone: 305-733-3633
- Fax:
- Phone: 305-733-3633
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ISMAEL
PITA
Title or Position: OWNER
Credential:
Phone: 786-499-5400