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General NPI Number Information
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NPI Number | 1043696651
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Entity Type | Organization
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Legal Business Name | REVLIFE LLC
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 4202 INVERRARY BLVD APT 75B
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City | LAUDERHILL
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State | FL
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Zip | 33319-4137
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Country | US
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Telephone | 954-658-7134
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Fax | 954-530-5894
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Provider Business Mailing Address
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Address Line | 4202 INVERRARY BLVD APT 75B
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City | LAUDERHILL
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State | FL
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Zip | 33319-4137
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Country | US
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Telephone | 954-658-7134
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Fax | 954-530-5894
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Authorized Official
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Title or Position | CEO
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Name | JOHN HANKERSON
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Credential |
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Telephone | 954-658-7134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246YC3302X
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Taxonomy Name | Physician Office Based Coding Specialist
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License Number |
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License Number State |
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