Organization
A REVOLUTION MEDICAL
Active
Organization
A REVOLUTION MEDICAL
Active
Parent organization
ALPHA HEALTH LLC
Other names
A Revolution Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALPHA HEALTH LLC
Authorized official
DR. ROBERT G CARDER DOM (MGR)
(407) 808-8763
Entity
Organization
Contact information
Practice address
711 N ORLANDO AVE, MAITLAND, FL 32751-4403
(407) 636-5391
(407) 986-4404
Mailing address
711 N ORLANDO AVE, MAITLAND, FL 32751-4403
(407) 636-5391
(407) 986-4404
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP2102
FLORIDA LICENSE
FL
Enumeration date
08/31/2017
Last updated
07/21/2022
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