Evolution Therapy Center Corp

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

MA34634 Issued in FL

Legal business name

EVOLUTION THERAPY CENTER CORP

Practice address

3900 NW 79TH Ave
Ste 954
Doral, FL 33166-6556

Phone

(305) 824-6661

NPI assigned

Jul 17, 2015

Last updated

Jul 17, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alberto Eduardo Bosch, M.T.

Title

P

Phone

(305) 824-6661

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1073997219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "STE 954",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "305-824-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "STE 954",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "305-824-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION THERAPY CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "BOSCH",
        "authorized_official_first_name": "ALBERTO",
        "authorized_official_middle_name": "EDUARDO",
        "authorized_official_title_or_position": "P",
        "authorized_official_telephone_number": "305-824-6661",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "MA34634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Nicole Estrada
• Clorinthe Etienne
• Marie K. Etienne, R.N., MPH
• Christina Eubanks
• Every Benefits Group Inc (New Health MD of Doral)
• Jocelande Exalant
• Excel Aesthetic Miami LLC
• Excellence Care Florida LLC
• Excellence Health Clinic, Inc
• Excellent Therapy Inc

• Physical Therapy Clinic/Center in Doral, FL
• Providers in Doral, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.