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Organization

REVIVE MEDICAL CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESUS RYAN ARVIZO JR. FNP-C (OWNER)
(480) 549-8865
Entity
Organization

Contact information

Practice address
239 N LITCHFIELD RD, GOODYEAR, AZ 85338-1249
(480) 549-8865
(520) 391-2936
Mailing address
12317 W LARKSPUR RD, EL MIRAGE, AZ 85335-5286

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
363L00000X
Nurse Practitioner
Primary
363LF0000X
Family Nurse Practitioner
363LG0600X
Gerontology Nurse Practitioner

Other

Enumeration date
07/26/2023
Last updated
07/25/2024
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