Evolving Vitality LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVOLVING VITALITY LLC

Doing business as

Evolving Vitality LLC

Practice address

2143 Burnice Dr
Clearwater, FL 33764-4859

Phone

(813) 279-9232

NPI assigned

Jul 27, 2022

Organization subpart

No

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

Authorized official

Name

Chad Robert Daso, OWNER

Title

Ceo

Phone

(813) 279-9232

Specialties & licenses 1

Addresses

Other names 1

• Evolving Vitality LLC Doing business as

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1740916170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2143 BURNICE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337644859",
            "telephone_number": "813-279-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 BURNICE DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337644859",
            "telephone_number": "813-279-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVING VITALITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A",
        "authorized_official_last_name": "DASO",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-279-9232",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolving Vitality LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Clearwater, FL
• Providers in Clearwater, 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 27, 2022; 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.