Evolution Studio LCKK LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

EVOLUTION STUDIO LCKK LLC

Practice address

3002 N Myrtle Ave Ste 3
Jacksonville, FL 32209-4228

Phone

(904) 881-6599

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Lashawnia M Mitchell

Title

Owner

Phone

(904) 881-6599

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1689344764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 N MYRTLE AVE STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322094228",
            "telephone_number": "904-881-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 N MYRTLE AVE STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322094228",
            "telephone_number": "904-881-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION STUDIO LCKK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LASHAWNIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-881-6599"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.