Provider Demographics
NPI:1427665967
Name:EVOLUTION HEALTH MANAGEMENT, CORP.
Entity type:Organization
Organization Name:EVOLUTION HEALTH MANAGEMENT, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMON MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-247-6770
Mailing Address - Street 1:11077 BISCAYNE BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7481
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11077 BISCAYNE BLVD STE 402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-7481
Practice Address - Country:US
Practice Address - Phone:786-247-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management