Provider Demographics
NPI:1972810711
Name:HEALTH EVOLUTION THERAPY CENTERS INC
Entity type:Organization
Organization Name:HEALTH EVOLUTION THERAPY CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:305-223-0188
Mailing Address - Street 1:2460 SW 137TH AVE STE 248-249
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2460 SW 137TH AVE STE 248-249
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-8803
Practice Address - Country:US
Practice Address - Phone:305-223-0188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH EVOLUTION THERAPY CENTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-31
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center