Healthcare Provider Details

I. General information

NPI: 1932043692
Provider Name (Legal Business Name): EVOLVE SKIN AND HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10-13 AVE AGUAS BUENAS
BAYAMON PR
00959-6677
US

IV. Provider business mailing address

10-13 AVE AGUAS BUENAS
BAYAMON PR
00959-6677
US

V. Phone/Fax

Practice location:
  • Phone: 939-353-8284
  • Fax:
Mailing address:
  • Phone: 939-353-8284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAHEEN COUNTS
Title or Position: OWNER
Credential: MD
Phone: 816-809-2452