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General NPI Number Information
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NPI Number | 1578236980
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Entity Type | Organization
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Legal Business Name | REVAMED HEALTHCARE PARTNERS LLC
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 7000 W PALMETTO PARK RD STE 201
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City | BOCA RATON
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State | FL
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Zip | 33433-3430
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Country | US
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Telephone | 561-708-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 8132 OKEECHOBEE BLVD STE B
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-2000
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Country | US
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Telephone | 561-290-1181
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Fax |
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Authorized Official
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Title or Position | CREDENTIALER
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Name | MELISSA STIELER
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Credential |
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Telephone | 561-432-2164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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