Healthcare Provider Details

I. General information

NPI: 1487590568
Provider Name (Legal Business Name): REVITACARE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S WARE BLVD STE 824
TAMPA FL
33619-4456
US

IV. Provider business mailing address

410 S WARE BLVD STE 824
TAMPA FL
33619-4456
US

V. Phone/Fax

Practice location:
  • Phone: 813-328-5941
  • Fax:
Mailing address:
  • Phone: 813-328-5941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJNARINE KEVIN ROOPNARINE
Title or Position: OWNER
Credential: DC, APRN
Phone: 813-328-5941