MEDICARE: REVIVE MEDICAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1548029697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REVIVE MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	7321 ASPIRE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1183
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7321 ASPIRE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1183
Country	:	US
Telephone Number	:	702-788-6219
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LISANDRA VEGA CASTRO
Credential	:
Telephone Number	:	702-788-6219

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	03/18/2024

Similar Medicare Providers

1982389946 — GLAMOURBRAIN MENTAL HEALTH LLC
Practice Location Address:

7321 ASPIRE CT
LAS VEGAS, NV
89113-1183

Practice Phone: 702-518-3533
Practice Fax:

1346925302 — GLAMOURBRAIN MENTAL HEALTH LLC
Practice Location Address:

7321 ASPIRE CT
LAS VEGAS, NV
89113-1183

Practice Phone: 702-518-3533
Practice Fax:

1407877921 — SMILE DENTAL, LLC
Practice Location Address:

6775 E LAKE MEAD BLVD , SUITE B9
LAS VEGAS, NV
89156-1183

Practice Phone: 702-450-7971
Practice Fax: 702-898-3232

1104253475 — MS. TAMICO TERRELL
Practice Location Address:

2750 W WIGWAM AVE APT 1183
LAS VEGAS, NV
89123-6648

Practice Phone: 702-205-1169
Practice Fax:

1356768725 — ANTHONY NEWMAN
Practice Location Address:

4249 N COMMERCE ST UNIT 1037
NORTH LAS VEGAS, NV
89032-1183

Practice Phone: 702-624-3739
Practice Fax:

1710878178 — LAUREN RAE CARREON
Practice Location Address:

2100 N MAIN ST
LAS CRUCES, NM
88001-1183

Practice Phone: 915-241-4485
Practice Fax:

Directions to “REVIVE MEDICAL CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.