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General NPI Number Information
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NPI Number | 1235953548
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Entity Type | Organization
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Legal Business Name | REVIVE HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 9015 TOWN CENTER PKWY UNIT 135
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5308
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Country | US
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Telephone | 941-263-8058
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Fax | 941-263-8074
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Provider Business Mailing Address
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Address Line | 9015 TOWN CENTER PKWY UNIT 135
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-5308
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Country | US
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Telephone | 941-263-8058
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Fax | 941-263-8074
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Authorized Official
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Title or Position | CFO
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Name | MAYANKKUMAR BALADEVBHAI PATEL
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Credential |
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Telephone | 845-903-2312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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