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Organization
REVITALOUNGE IV HYDRATION AND WELLNESS, PLLC
Active
Organization
REVITALOUNGE IV HYDRATION AND WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAZIM RISHMAWI MD (OWNER, MEDICAL DIRECTOR)
(859) 533-5361
Entity
Organization
Contact information
Practice address
3948 FOUNTAINBLUE LN STE 120, LEXINGTON, KY 40513-8315
(859) 334-0806
Mailing address
3948 FOUNTAINBLUE LN STE 120, LEXINGTON, KY 40513-8315
(859) 334-0806
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/29/2026
Last updated
08/29/2026
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