NPIMap

Organization Active NPI

TLC Recovery Center of South Florida

Doing business as Evolutions Treatment Center

  • Pharmacy
  • Fort Lauderdale, FL
National Provider Identifier
1770027187
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
TLC RECOVERY CENTER OF SOUTH FLORIDA
Doing business as
Evolutions Treatment Center
Practice address
2901 W Cypress Creek Rd Ste 123
Fort Lauderdale, FL 33309-1732
Phone
(954) 915-7444
Fax
(954) 206-0372
NPI assigned
Dec 5, 2016
Last updated
May 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Authorized official

Name
Gedale M Fenster
Title
Ceo
Phone
(954) 915-7444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

2901 W Cypress Creek Rd Ste 123
Fort Lauderdale, FL 33309-1732

Mailing address

2900 W Cypress Creek Rd
Suite 2
Fort Lauderdale, FL 33309-1715
Phone (954) 915-7444

Other names 1

  • Evolutions Treatment Center Doing business as

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
10D2071681TLC Recovery Center of South Florida, LLC2901 W Cypress Creek Rd #123, Fort Lauderdale, FL 33309Certificate of waiverDec 6, 2026

National Provider Directory

National Provider Directory

Locations

2900 W Cypress Creek Rd
Ste 2
Fort Lauderdale, FL 33309
Phone (954) 803-1952

2901 W Cypress Creek Rd
Ste 123
Ft Lauderdale, FL 33309
Phone (954) 915-7444

Practitioners & affiliated clinicians

Practitioners 7

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": "1480896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1770027187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W CYPRESS CREEK RD",
            "address_2": "SUITE 2",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091715",
            "telephone_number": "954-915-7444",
            "fax_number": "954-206-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W CYPRESS CREEK RD STE 123",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091732",
            "telephone_number": "954-915-7444",
            "fax_number": "954-206-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC RECOVERY CENTER OF SOUTH FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-05",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "FENSTER",
        "authorized_official_first_name": "GEDALE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-915-7444"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolutions Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolutions Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.