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Organization
REVOLUTIONARY HEALTH
Active
Organization
REVOLUTIONARY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WIKENSON JESTINE (MANAGER)
(561) 713-4819
Entity
Organization
Contact information
Practice address
3175 S CONGRESS AVE STE 203, PALM SPRINGS, FL 33461-2562
(561) 328-7527
Mailing address
3175 S CONGRESS AVE STE 203, PALM SPRINGS, FL 33461-2562
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
261QU0200X
Urgent Care Clinic/Center
—
NULL
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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