Evolution IV, LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

EVOLUTION IV, LLC

Practice address

14615 San Pedro Ave Ste 105
San Antonio, TX 78232-4364

Phone

(914) 906-4004

NPI assigned

Dec 14, 2020

Organization subpart

No

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

Authorized official

Name

Lautaro Sanfilippo

Title

Ceo

Phone

(347) 306-0338

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1083200075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14615 SAN PEDRO AVE STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324364",
            "telephone_number": "914-906-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14615 SAN PEDRO AVE STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324364",
            "telephone_number": "914-906-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION IV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "SANFILIPPO",
        "authorized_official_first_name": "LAUTARO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-306-0338"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infusion Therapy Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Infusion Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.