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:MGR
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 1:1257 SW MARTIN HWY UNIT 1527
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34991-5063
Mailing Address - Country:US
Mailing Address - Phone:561-299-1203
Mailing Address - Fax:561-264-1350
Practice Address - Street 1:1257 SW MARTIN HWY UNIT 1527
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34991-5063
Practice Address - Country:US
Practice Address - Phone:561-299-1203
Practice Address - Fax:561-264-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty