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General NPI Number Information
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NPI Number | 1275250193
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Entity Type | Organization
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Legal Business Name | EVOL HEALTH LLC
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 1257 SW MARTIN HWY UNIT 1527
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City | PALM CITY
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State | FL
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Zip | 34991-5063
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Country | US
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Telephone | 561-299-1203
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Fax | 561-264-1350
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Provider Business Mailing Address
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Address Line | 1257 SW MARTIN HWY UNIT 1527
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City | PALM CITY
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State | FL
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Zip | 34991-5063
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Country | US
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Telephone | 561-299-1203
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Fax | 561-264-1350
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Authorized Official
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Title or Position | MGR
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Name | JESSICA RODRIGUEZ
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Credential |
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Telephone | 561-299-1203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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