Healthcare Provider Details

I. General information

NPI: 1134091614
Provider Name (Legal Business Name): REVIVA BY HH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 CALLE 42 SE URB. REPARTO METROPOLITANO
SAN JUAN PR
00921
US

IV. Provider business mailing address

PO BOX 2598
GUAYNABO PR
00970-2598
US

V. Phone/Fax

Practice location:
  • Phone: 787-637-6274
  • Fax:
Mailing address:
  • Phone: 787-637-6274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HARRY EMILIO NEGRON JUDICE
Title or Position: PRINCIPAL
Credential: MD
Phone: 787-637-6274