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Organization

REVIVE FUNCTIONAL REHABILITATION CENTER

Active
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Organization

REVIVE FUNCTIONAL REHABILITATION CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID E FAIRLEIGH MD (OWNER)
(850) 291-3618
Entity
Organization

Contact information

Practice address
3246 COVE BEND DR, TAMPA, FL 33613-2752
(850) 291-3618
Mailing address
25 MAR VISTA CIR, PENSACOLA, FL 32507-3486
(850) 291-3618

Taxonomy

Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary

Other

Enumeration date
03/31/2025
Last updated
03/31/2025
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