Evolution Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EVOLUTION PSYCHIATRY, LLC

Practice address

915 Middle River Dr Ste 103C
Fort Lauderdale, FL 33304-3559

Phone

(774) 365-9192

NPI assigned

Jan 19, 2022

Organization subpart

No

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

Authorized official

Name

Shannan Victorino

Title

Owner

Phone

(774) 365-9192

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1679225825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 SAN CLARA DR # 18C",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334455429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MIDDLE RIVER DR STE 103C",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043559",
            "telephone_number": "774-365-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-19",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "VICTORINO",
        "authorized_official_first_name": "SHANNAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-365-9192"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Fort Lauderdale, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.