Organization
PURPOSELY EVOLVING
Active
Other names
Purposely Evolving Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE PASCHAL APRN (OWNER)
(727) 937-6060
Entity
Organization
Contact information
Practice address
1810 S PINELLAS AVE STE B, TARPON SPRINGS, FL 34689-1989
(727) 937-6060
(727) 937-6030
Mailing address
1810 S PINELLAS AVE STE B, TARPON SPRINGS, FL 34689-1989
(727) 937-6060
(727) 937-6030
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013086917
NPI
FL
01
—
1083178040
NPI
FL
Enumeration date
01/23/2023
Last updated
08/09/2023
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