| Entity Name: | EVOLVE WELLNESS AND RECOVERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Dec 2023 (a year ago) |
| Document Number: | L23000539855 |
| FEI/EIN Number | 93-4739572 |
| Address: | 4417 SW 34TH TERRACE, FT. LAUDERDALE, FL 33312 |
| Mail Address: | 4417 SW 34TH TERRACE, FT. LAUDERDALE, FL 33312 |
| ZIP code: | 33312 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154177012 | 2024-04-30 | 2024-04-30 | 4417 SW 34TH TER, FT LAUDERDALE, FL, 333125420, US | 4417 SW 34TH TER, FT LAUDERDALE, FL, 333125420, US | |||||||||||||||||
|
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| Phone | +1 954-483-8348 |
Authorized person
| Name | DR. STEVEN M SUASTEGUI |
| Role | MEDICAL DIRECTOR |
| Phone | 9544838348 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RA0401X - Addiction Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SUASTEGUI, STEVEN M | Agent | 4417 SW 34TH TERRACE, FT. LAUDERDALE, FL 33312 |
| Name | Role | Address |
|---|---|---|
| SUASTEGUI, STEVEN M | Manager | 4417 SW 34TH TERRACE, FT. LAUDERDALE, FL 33312 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| Florida Limited Liability | 2023-12-05 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
