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Organization
REVIVE WELLNESS BAR LLC
Active
Organization
REVIVE WELLNESS BAR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SARAH YVETTE SANCHEZ APRN (OWNER-FNP-C)
(407) 791-0613
Entity
Organization
Contact information
Practice address
3988 MAGENTA PL, SAINT CLOUD, FL 34772-6411
(407) 791-0613
Mailing address
3988 MAGENTA PL, SAINT CLOUD, FL 34772-6411
(407) 791-0613
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
12/31/2024
Last updated
01/27/2025
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