Evolve Pediatric LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVOLVE PEDIATRIC LLC

Practice address

10250 SW 56TH St Ste C203
Miami, FL 33165-7098

Phone

(786) 443-9749

NPI assigned

Jul 23, 2019

Organization subpart

No

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

Authorized official

Name

Victor Pena

Title

President

Phone

(786) 443-9749

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1326691866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 SW 56TH ST STE C203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657098",
            "telephone_number": "786-443-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 SW 56TH ST STE C203",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331657098",
            "telephone_number": "786-443-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE PEDIATRIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-443-9749"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evolution Medical Centers Inc
• Evolution Nurse Registry Inc.
• Evolution Nurse Registry Inc.
• Evolution Rehabilitation Center Inc
• Evolv Wellness
• Evolve Pediatric Ppec, LLC
• Evolve Rehabilitation & Wellness Center Corp
• Rebeca Evora Miro, PSY.D., BCBA
• Armando Tomas Evora, FNP
• Leannet Evora

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.