Organization Active NPI

Evara Therapeutics, Inc.

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1619777877
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EVARA THERAPEUTICS, INC.
Practice address
26286 US Highway 19 N Ste B
Clearwater, FL 33761-4506
Phone
(727) 824-8100
NPI assigned
Mar 17, 2025
Last updated
Apr 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Elodie Dorso
Title
President/Ceo
Phone
(727) 824-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

26286 US Highway 19 N Ste B
Clearwater, FL 33761-4506

Mailing address

14100 58TH St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251009002381 FL Part B Supplier - Clinic/Group Practice 2961909411 Receives reassigned benefits from 2 practitioners
Practice locations: Clearwater, 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
10D2332595Evara Therapeutics Inc26286 US Hwy 19 N Suite B-100, Clearwater, FL 33761Provider-performed microscopyOct 21, 2027

National Provider Directory

National Provider Directory

Locations

14100 58th St N
#B100
Clearwater, FL 33760

26286 US Highway 19 N
#B100
Clearwater, FL 33761

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1619777877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26286 US HIGHWAY 19 N STE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614506",
            "telephone_number": "727-824-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVARA THERAPEUTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "DORSO",
        "authorized_official_first_name": "ELODIE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "727-824-8100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.