Evolve Hydration and Wellness LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVOLVE HYDRATION AND WELLNESS LLC

Practice address

187 Sabal Palm Dr Ste 100
Longwood, FL 32779-2595

Phone

(407) 353-1336

NPI assigned

Aug 31, 2023

Organization subpart

No

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

Authorized official

Name

Cameka Campbell, NURSE PRACTITIONERNPI 1043753437

Title

Owner

Phone

(407) 353-1336

Specialties & licenses 2

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Cameka Campbell

  • Family Nurse Practitioner
  • Longwood, FL
  • NPI 1043753437
  NPD Authorized official

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1245015759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 SABAL PALM DR STE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327792595",
            "telephone_number": "407-353-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 SABAL PALM DR STE 100",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327792595",
            "telephone_number": "407-353-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE HYDRATION AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "CAMEKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-353-1336",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitra Esfahani Zadeh
• Heather Marie Esteban
• Luz Divina Estrella Guzman
• Katelyn Evans
• Madison Everill
• Evolve Speacialty Infusion PLLC
• Excel Elite Labs LLC
• Express Care Clinic Group
• Express Care Clinic LLC
• Eye Physicians of Central Florida

• Clinic/Center in Longwood, FL
• Providers in Longwood, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.