# EVOLUTION HEALTH & PERFORMANCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376161380
- **Authorized official:** BOBBY JOHN ARDILA PA (OWNER/PA)
- **Authorized official phone:** (407) 739-2395

## Contact information

- **Practice address:** 244 S. PALMETTO AVE, DAYTONA BEACH, FL 32114
- **Practice address phone:** (386) 310-2385
- **Practice address fax:** (386) 233-9488
- **Mailing address:** 244 S. PALMETTO AVE, DAYTONA BEACH, FL 32114
- **Mailing address phone:** (386) 310-2385
- **Mailing address fax:** (386) 233-9488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 07/07/2020
- **Last updated:** 07/07/2020