Organization
REVITALIZE MENTAL HEALTH & INTEGRATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE LEE THOMAS APRN, PMHNP (OWNER)
(734) 558-3401
Entity
Organization
Contact information
Practice address
8225 STATE ROAD 54, TRINITY, FL 34655-3016
(727) 242-8800
Mailing address
1504 OHIO AVE, DUNEDIN, FL 34698-4514
(734) 558-3401
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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