| Evolution Psychiatry, Llc | |
|
915 Middle River Dr Ste 103c Fort Lauderdale FL 33304-3559 | |
| (774) 365-9192 | |
| Not Available |
| Full Name | Evolution Psychiatry, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 915 Middle River Dr Ste 103c, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Shannan Victorino (OWNER) |
| Authorized Official Contact | 7743659192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Psychiatry, Llc 3012 San Clara Dr # 18c Delray Beach FL 33445-5429 Ph: () - | Evolution Psychiatry, Llc 915 Middle River Dr Ste 103c Fort Lauderdale FL 33304-3559 Ph: (774) 365-9192 |
| NPI Number | 1679225825 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 01/19/2022 |
| Certification Date | 01/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679225825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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