Organization · Type 2 NPI
Revita Medical Center LLC
Adult Medicine Physician · Homestead, FL
NPI number
1811723869
Active
Practice location
724 S Krome Ave
Homestead, FL 33030-7264
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | None listed |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
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About NPI 1811723869
Revita Medical Center LLC's National Provider Identifier is 1811723869, issued on Sep 9, 2024. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Homestead, FL. The record was last updated on Nov 24, 2025.