Healthcare Provider Details

I. General information

NPI: 1922918259
Provider Name (Legal Business Name): REVIVE SPINE AND SPORTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 TAMIAMI TRL N STE 120
NAPLES FL
34103-4135
US

IV. Provider business mailing address

5877 HAMMOCK ISLES CIR
NAPLES FL
34119-4648
US

V. Phone/Fax

Practice location:
  • Phone: 239-990-7453
  • Fax:
Mailing address:
  • Phone: 917-533-2864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCO EDWARD VIGNA
Title or Position: OWNER
Credential: MD
Phone: 917-533-2864