# REVIVAL ORTHOPAEDICS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285837492
- **Authorized official:** DR. MARK BRIDGES M.D. (PHYSICIAN)
- **Authorized official phone:** (305) 694-9400

## Contact information

- **Practice address:** 1190 NW 95TH ST, SUITE 305, MIAMI, FL 33150-2063
- **Practice address phone:** (305) 694-9400
- **Practice address fax:** (305) 693-6942
- **Mailing address:** 1190 NW 95TH ST, SUITE 305, MIAMI, FL 33150-2063
- **Mailing address phone:** (305) 694-9400
- **Mailing address fax:** (305) 693-6942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME91496 | FL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | ME93941 | FL | — |

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 12/18/2008