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Individual
JOSE FELIX REVOLLO
Active
Individual
JOSE FELIX REVOLLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R239041
MD
163WR0400X
Rehabilitation Registered Nurse
Primary
RN1039386
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R239041
MD
Other
Enumeration date
11/20/2019
Last updated
07/08/2026
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