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AVON PARK MEDICAL GROUP, LLC.
NPI 1225641954
Clinic/Center in Avon Park, FL

Active since August 24, 2020
1023 US HIGHWAY 27 S, AVON PARK, FL 33825(863) 201-7329(863) 201-7251 Get Directions Write a Review

NPPES record last updated: April 25, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 10, 2025, Jan 8, 2025, Aug 24, 2020 (3 updates tracked since 2020).

About Avon Park Medical Group, Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVON PARK MEDICAL GROUP, LLC. (NPI 1225641954), doing business as Revello Medical, is a healthcare organization registered as a clinic/center in Avon Park, Florida and active in the NPI registry since August 2020. The organization lists Antonio Calvo, Cfo, as its authorized official.

NPPES Registry Identity

NPI1225641954
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameAVON PARK MEDICAL GROUP, LLC.
Location Address1023 US HIGHWAY 27 SAvon Park, FL 33825-5107
Mailing Address5901 Webb RdTampa, FL 33615-3219 · (813) 888-8215 · Fax (813) 885-5398
Phone(863) 201-7329
Fax(863) 201-7251
Organization SubpartNo
Authorized OfficialAntonio CalvoCfo · (813) 888-8215
Enumeration DateAugust 24, 2020
Last NPPES UpdateApril 25, 20253 updates tracked since enumeration
NPPES CertifiedApril 25, 2025
✔ NPI 1225641954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
1023 US HIGHWAY 27 S, Avon Park, FL 33825
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Other Names 1

Doing Business AsRevello Medical

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Avon Park Medical Group, Llc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Avon Park Medical Group, LLC., which bills Medicare for the services this clinician delivers.

Clinician (1)

Manuel Montalvan Rodriguez, APRN
Nurse Practitioner
NPI 1346712049
7400 DOCS GROVE CIR
Orlando, FL 32819
(407) 352-9717
✔ PECOS57 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avon Park Medical Group, LLC.'s NPI number?

The NPI number for Avon Park Medical Group, LLC. is 1225641954. It was assigned to this organization in the NPPES registry on August 24, 2020. The provider is doing business as Revello Medical.

Where is Avon Park Medical Group, LLC. located?

Avon Park Medical Group, LLC. is located at 1023 Us Highway 27 S, Avon Park, FL 33825. The listed phone number is (863) 201-7329.

What is Avon Park Medical Group, LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Avon Park Medical Group, LLC. enrolled in Medicare?

Yes. Avon Park Medical Group, LLC. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Avon Park Medical Group, LLC.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Avon Park Medical Group, LLC.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Avon Park Medical Group, LLC. was last updated on April 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.