Individual
DR. DONALD RAY REVIS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N FEDERAL HWY, SUITE 301, FORT LAUDERDALE, FL 33305-1618
(954) 630-2009
(954) 630-2094
Mailing address
649 SW 8TH TER, FORT LAUDERDALE, FL 33315-1049
(954) 760-4727
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME0076322
FL
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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