Provider Demographics
NPI:1285204990
Name:REVIVE HEALTH ASSOCIATES, LLC
Entity Type:Organization
Organization Name:REVIVE HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJNARINE
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:ROOPNARINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, APRN
Authorized Official - Phone:813-419-1399
Mailing Address - Street 1:410 S WARE BLVD STE 828
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4469
Mailing Address - Country:US
Mailing Address - Phone:813-419-1399
Mailing Address - Fax:813-580-7161
Practice Address - Street 1:410 S WARE BLVD STE 828
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4469
Practice Address - Country:US
Practice Address - Phone:813-419-1399
Practice Address - Fax:813-580-7161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-26
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty