Organization
EVOLVE NEURO THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAZMIN PERALTA OTR/L (OWNER)
(407) 460-8500
Entity
Organization
Contact information
Practice address
111 E MONUMENT AVE UNIT 410, KISSIMMEE, FL 34741-5774
(407) 904-5285
Mailing address
111 E MONUMENT AVE UNIT 410, KISSIMMEE, FL 34741-5774
(407) 904-5285
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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