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Organization
REVISION THERAPY
Active
Organization
REVISION THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICASIO RENALDO (OWNER)
(727) 222-0558
Entity
Organization
Contact information
Practice address
400 N TAMPA ST, 1550 PMB 767259, TAMPA, FL 33602
(727) 222-0558
Mailing address
400 N TAMPA ST, 1550 PMB 767259, TAMPA, FL 33602
(727) 222-0558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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