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Organization
REVIVALIFE HEALTH PLLC
Active
Organization
REVIVALIFE HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY HIDALGO (MANAGING MEMBER)
(407) 801-1065
Entity
Organization
Contact information
Practice address
100 E NEW YORK AVE STE 103, DELAND, FL 32724-5576
(407) 901-7215
Mailing address
100 E. NEW YORK AVE STE 103, #1011, DELAND, FL 32724-5576
(407) 801-1065
(407) 801-1065
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/10/2025
Last updated
05/05/2026
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