# REVIVAL MED CENTERS, LLC

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

## Provider details

- **NPI number:** 1871311076
- **Authorized official:** ROSA ALBA PEREZ (OWNER)
- **Authorized official phone:** (561) 886-8459

## Contact information

- **Practice address:** 8353 SW 124TH ST STE 207A, MIAMI, FL 33156-5847
- **Practice address phone:** (786) 443-5833
- **Mailing address:** 8353 SW 124TH ST STE 207A, MIAMI, FL 33156-5847
- **Mailing address phone:** (786) 443-5833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2024
- **Last updated:** 07/15/2025