MEDICARE: REVA, INC.

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	341600000X	Ambulance
2	3416A0800X	Air Ambulance
3	3416A0800X	Air Ambulance	406	FL

General Provider Information

NPI Number	:	1568580926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REVA, INC.

Provider Business Mailing Address
First Line	:	1745 NW 51ST PL
Second Line	:	HANGAR 73
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-2755
Country	:	US
Telephone Number	:	954-730-9300
Fax Number	:	888-422-5785

Provider Business Practice Location Address
First Line	:	2101 W COMMERCIAL BLVD STE 5100
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3055
Country	:	US
Telephone Number	:	954-730-9300
Fax Number	:	888-422-5785

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. STUART HAYMAN
Credential	:
Telephone Number	:	954-776-2776

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/29/2024

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Directions to “REVA, INC. ” Practice Location

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