| Evolution Primary Care | |
|
11264 Boyette Rd Riverview FL 33569-8009 | |
| (813) 672-2014 | |
| (866) 386-1733 |
| Full Name | Evolution Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 11264 Boyette Rd, Riverview, Florida |
| Authorized Official Name and Position | Matthew Dowdy (OWNER) |
| Authorized Official Contact | 8136722014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Primary Care 11264 Boyette Rd Riverview FL 33569-8009 Ph: (813) 672-2014 | Evolution Primary Care 11264 Boyette Rd Riverview FL 33569-8009 Ph: (813) 672-2014 |
| NPI Number | 1609327311 |
|---|---|
| Provider Enumeration Date | 10/18/2016 |
| Last Update Date | 02/12/2021 |
| Medicare PECOS PAC ID | 2860758489 |
|---|---|
| Medicare Enrollment ID | O20171114001889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609327311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME91905 (Florida) | Primary |
| Provider Name | Matthew A Dowdy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831183961 PECOS PAC ID: 1456306612 Enrollment ID: I20050321000711 |
| Provider Name | Tracy Chery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083020861 PECOS PAC ID: 4284995036 Enrollment ID: I20180219002399 |
| Provider Name | Lauren Blair Arcilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376013912 PECOS PAC ID: 7012254550 Enrollment ID: I20190123000077 |
| Provider Name | Jacob Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912605395 PECOS PAC ID: 2567823065 Enrollment ID: I20230801000092 |
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