# REVITA MEDICAL CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1811723869
- **Authorized official:** DIEGO FERREIRA (MANAGER)
- **Authorized official phone:** (786) 339-8248

## Contact information

- **Practice address:** 724 S KROME AVE, HOMESTEAD, FL 33030-7264
- **Practice address phone:** (786) 922-6393
- **Mailing address:** 724 S KROME AVE, HOMESTEAD, FL 33030-7264
- **Mailing address phone:** (786) 339-8248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2024
- **Last updated:** 11/24/2025