Healthcare Provider Details

I. General information

NPI: 1841106176
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL REVELS DPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13887 NARCOOSSEE RD STE 205
ORLANDO FL
32832-7221
US

IV. Provider business mailing address

13887 NARCOOSSEE RD STE 205
ORLANDO FL
32832-7221
US

V. Phone/Fax

Practice location:
  • Phone: 407-930-7862
  • Fax:
Mailing address:
  • Phone: 407-930-7862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44943
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: