Organization · Type 2 NPI

Revelation Family Medicine Office, Llc.

Adult Medicine Physician · Hollywood, FL

NPI number 1912472200 Active

Practice location

3939 Hollywood Blvd Ste 300B
Hollywood, FL 33021-6749

Specialties and licenses

TaxonomyCodeLicense
Adult Medicine Physician Primary 207QA0505XNone listed

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

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About NPI 1912472200

Revelation Family Medicine Office, Llc.'s National Provider Identifier is 1912472200, issued on Oct 12, 2018. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Hollywood, FL. The record was last updated on Oct 12, 2018.