# IV LEAGUE HYDRATION THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** revIVe Hydration Therapy & Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811620016
- **Authorized official:** MR. SIDNEY BRADLEY (CEO)
- **Authorized official phone:** (813) 769-9127

## Contact information

- **Practice address:** 2122 S DALE MABRY HWY, TAMPA, FL 33629-6312
- **Practice address phone:** (813) 769-9127
- **Mailing address:** 3709 W JETTON AVE STE A1, TAMPA, FL 33629-5115
- **Mailing address phone:** (813) 769-9127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171400000X | Health & Wellness Coach | — | NULL | Yes |
| 171400000X | Health & Wellness Coach | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2022
- **Last updated:** 07/05/2022