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Organization
HEALTH&LIFE EVOLUTION LLC
Active
Organization
HEALTH&LIFE EVOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL JOSUE VALLENILLA SA-C (PRESIDENT)
(407) 272-8505
Entity
Organization
Contact information
Practice address
14047 WALCOTT AVE, ORLANDO, FL 32827-7471
(407) 272-8505
Mailing address
14047 WALCOTT AVE, ORLANDO, FL 32827-7471
(407) 272-8505
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/05/2021
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