Organization Active NPI

Evolve Wellness and Recovery

  • Addiction Medicine (Internal Medicine) Physician
  • Plantation, FL
National Provider Identifier
1154177012
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
Legal business name
EVOLVE WELLNESS AND RECOVERY
Practice address
4161 NW 5TH St Ste 201
Plantation, FL 33317-2101
Phone
(954) 859-6051
Fax
(954) 349-1716
NPI assigned
Apr 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Dr. Steven M Suastegui, MDNPI 1871144618
Title
Medical Director
Phone
(954) 483-8348

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X Primary

Addresses

Primary practice location

4161 NW 5TH St Ste 201
Plantation, FL 33317-2101

Mailing address

4161 NW 5TH St Ste 201
Plantation, FL 33317-2101
Phone (954) 859-6051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250325000760 FL Part B Supplier - Clinic/Group Practice 0840713475 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2315316Evolve Wellness and Recovery LLC4161 NW 5TH St Ste 201, Plantation, FL 33317Certificate of waiverDec 10, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1154177012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 NW 5TH ST STE 201",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172101",
            "telephone_number": "954-859-6051",
            "fax_number": "954-349-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 NW 5TH ST STE 201",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172101",
            "telephone_number": "954-859-6051",
            "fax_number": "954-349-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE WELLNESS AND RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "SUASTEGUI",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-483-8348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.