Evolvegene, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EVOLVEGENE, LLC

Practice address

12105 28TH St N
Unit a
Saint Petersburg, FL 33716-1817

Phone

(727) 623-4052

Fax

(727) 202-8148

NPI assigned

Jan 23, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Mike Cecchi

Title

President

Phone

(203) 641-5622

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1366989808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 28TH ST N",
            "address_2": "UNIT A",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337161817",
            "telephone_number": "727-623-4052",
            "fax_number": "727-202-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 28TH ST N",
            "address_2": "UNIT A",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337161817",
            "telephone_number": "727-623-4052",
            "fax_number": "727-202-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVEGENE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "CECCHI",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-641-5622",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; 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.