Healthcare Provider Details

I. General information

NPI: 1760341572
Provider Name (Legal Business Name): REVAMP CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2026
Last Update Date: 01/17/2026
Certification Date: 01/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33322 DARLEY DALE TRL
WESLEY CHAPEL FL
33545-5341
US

IV. Provider business mailing address

33322 DARLEY DALE TRL
WESLEY CHAPEL FL
33545-5341
US

V. Phone/Fax

Practice location:
  • Phone: 813-245-6505
  • Fax:
Mailing address:
  • Phone: 813-245-6505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: COLISHA PLUMMER
Title or Position: OWNER
Credential:
Phone: 813-245-6505