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General NPI Number Information
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NPI Number | 1093505125
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Entity Type | Organization
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Legal Business Name | EVARA HEALTH SPECIALTY SERVICES, INC.
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 14100 58TH ST N
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City | CLEARWATER
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State | FL
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Zip | 33760-9900
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Country | US
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Telephone | 727-824-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 14100 58TH ST N
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City | CLEARWATER
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State | FL
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Zip | 33760-9900
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Country | US
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Telephone | 727-824-8181
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Fax | 727-824-8181
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ELODIE DORSO
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Credential |
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Telephone | 727-824-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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