Healthcare Provider Details

I. General information

NPI: 1730007675
Provider Name (Legal Business Name): EVERGRACE HEALTH GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 SE RIVERSIDE DR
STUART FL
34994-2584
US

IV. Provider business mailing address

382 NE 191ST ST PMB 912121
MIAMI FL
33179-3899
US

V. Phone/Fax

Practice location:
  • Phone: 845-597-3206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SRI RAMESH EEVANI
Title or Position: AUTHORIZED OFFICIAL
Credential: DR.
Phone: 908-720-5815