Provider Demographics
NPI:1275250193
Name:EVOL HEALTH LLC
Entity Type:Organization
Organization Name:EVOL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-299-1203
Mailing Address - Street 1:8051 N TAMIAMI TRL STE E6
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2067
Mailing Address - Country:US
Mailing Address - Phone:561-299-1203
Mailing Address - Fax:561-264-1350
Practice Address - Street 1:8051 N TAMIAMI TRL STE E6
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2067
Practice Address - Country:US
Practice Address - Phone:561-299-1203
Practice Address - Fax:561-264-1350
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HSC SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-21
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty