Organization
EVOLVE THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILADY VELAZQUEZ DE JESUS (OWNER)
(787) 974-7513
Entity
Organization
Contact information
Practice address
111 CALLE DUFRENSE, ESQUINA MANUEL CRUZ, HUMACAO, PR 00791
(939) 328-7297
Mailing address
PO BOX 7303, PONCE, PR 00732-7303
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020-2
JUNTA EXAMINADORA DE TERAPIA OCUPACIONAL
PR
Enumeration date
07/06/2023
Last updated
07/10/2023
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