Individual
KIMBERLY ELIZABETH REVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2400 S HWY 27, CLERMONT, FL 34711-6816
(352) 394-0212
Mailing address
2301 STANFORD CT, CLERMONT, FL 34711-7451
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00821100
NJ
Other
Enumeration date
04/09/2018
Last updated
01/24/2022
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