Organization Active NPI

Evalumd Inc

  • Internal Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1013889369
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
EVALUMD INC
Practice address
4131 University Blvd S Ste 13
Jacksonville, FL 32216-4346
Phone
(321) 888-0733
NPI assigned
Sep 18, 2025
Last updated
Sep 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Olga Petrova
Title
Manager
Phone
(321) 888-0733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4131 University Blvd S Ste 13
Jacksonville, FL 32216-4346

Mailing address

4131 University Blvd S Ste 13
Jacksonville, FL 32216-4346
Phone (321) 888-0733

National Provider Directory

National Provider Directory

Locations

4131 University Blvd S
Ste 13
Jacksonville, FL 32216
Phone (904) 731-7830

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1013889369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S STE 13",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164346",
            "telephone_number": "321-888-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 UNIVERSITY BLVD S STE 13",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164346",
            "telephone_number": "321-888-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVALUMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "PETROVA",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-888-0733"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.