# EVOLVES VASCULAR LAB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Atlantic Cardiovacular & Thoracic Surgeons, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548699606
- **Authorized official:** VICKY BROWNING (OFFICE MANAGER)
- **Authorized official phone:** (386) 672-9501

## Contact information

- **Practice address:** 588 STERTHAUS DR, ORMOND BEACH, FL 32174-5128
- **Practice address phone:** (386) 672-9501
- **Practice address fax:** (386) 673-0308
- **Mailing address:** 588 STERTHAUS DR, ORMOND BEACH, FL 32174-5128
- **Mailing address phone:** (386) 672-9501
- **Mailing address fax:** (386) 673-0308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 58979 | FL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 58979 | FL | — |

## Other

- **Enumeration date:** 11/08/2013
- **Last updated:** 11/13/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 041690800 | — | FL |
| 01 | — | 1245226695 | NPI | — |
| 01 | — | 1932195385 | NPI | FL |
| 05 | — | 371580900 | — | FL |