PURPOSELY EVOLVING NPI 1609582782

NPI Information

  • NPI: 1609582782
  • Provider Name: PURPOSELY EVOLVING
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: PURPOSELY EVOLVING MEDICAL CLINIC
  • CLIA Number: 10D2262074
  • Address: 1810 S PINELLAS AVE STE B
    TARPON SPRINGS, FL
    ZIP 34689
  • Phone: (727) 937-6060

Map and Directions

Get Directions

NPI Details

PURPOSELY EVOLVING is a primary care clinic center in Tarpon Springs, FL. PURPOSELY EVOLVING NPI is 1609582782. The provider is registered as an organization entity type.
The provider Is Doing Business As Purposely Evolving Medical Clinic.

The provider's business location address is:

1810 S PINELLAS AVE STE B
TARPON SPRINGS, FL
ZIP 34689-989
Phone: (727) 937-6060
Fax: (727) 937-6030

The provider's authorized official is Dominique Paschal .
The authorized official title is Owner and has the following contact phone number (727) 937-6060.

The CLIA number assigned to this NPI record is 10D2262074 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/23/2023 and was last updated on 8/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11083178040OTHERFLORIDANPI
21013086917OTHERFLORIDANPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI