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Organization

REVIVIFY BEAUTY SALON & SPA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ABIGAIL AZALEA RICE (OWNER)
(407) 205-9393
Entity
Organization

Contact information

Practice address
5041 EDGEWATER DR, ORLANDO, FL 32810-5226
(407) 205-9393
(407) 201-4460
Mailing address
1600 THE OAKS BLVD, KISSIMMEE, FL 34746-3829
(407) 577-8136
(407) 201-4460

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
09/29/2025
Last updated
09/29/2025
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