Organization
FREEDOM22 SRQ
Active
Other names
Revitalized Health
Organization subpart
No
Provider details
NPI number
Authorized official
ARUNDATHI RAO (OWNER)
(904) 306-6789
Entity
Organization
Contact information
Practice address
1958 PROSPECT ST, SARASOTA, FL 34239-2222
(941) 313-2393
(904) 980-9302
Mailing address
13223 SWALLOWTAIL DR, LAKEWOOD RANCH, FL 34202-8240
(941) 313-2393
(904) 980-9302
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
02/05/2025
Last updated
04/16/2026
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