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REVIVE PHARMACY
NPI 1558610527
Pharmacy - Community/Retail Pharmacy in Fort Myers, FL

Active since September 05, 2012
16205 S TAMIAMI TRL, SUITE # 6, FORT MYERS, FL 33908(239) 204-4223(239) 204-4224 Get Directions Write a Review

NPPES record last updated: February 26, 2016. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Revive Pharmacy NPPES

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

REVIVE PHARMACY (NPI 1558610527) is a healthcare organization registered as a community/retail pharmacy in Fort Myers, Florida and active in the NPI registry since September 2012. The organization lists Nicole Deforte, Owner, as its authorized official.

NPPES Registry Identity

NPI1558610527
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameREVIVE PHARMACY INC
Location Address16205 S TAMIAMI TRL, SUITE # 6Fort Myers, FL 33908-5304
Mailing Address16205 S Tamiami Trl, Suite # 6Fort Myers, FL 33908-5304 · (239) 204-4223 · Fax (239) 204-4224
Phone(239) 204-4223
Fax(239) 204-4224
Organization SubpartNo
Authorized OfficialNicole DeforteOwner · (239) 204-4223
Enumeration DateSeptember 5, 2012
Last NPPES UpdateFebruary 26, 2016
✔ NPI 1558610527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in FL · PH26342
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
16205 S TAMIAMI TRL, Fort Myers, FL 33908
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Other Names 1

Doing Business AsRevive Pharmacy

Other Identifiers 2

Other2136822Pk
Medicaid006790300FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revive Pharmacy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20131206000487Non-DME Part B · OtherDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

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 Revive Pharmacy Inc's NPI number?

The NPI number for Revive Pharmacy Inc is 1558610527. It was assigned to this organization in the NPPES registry on September 5, 2012. The provider is doing business as Revive Pharmacy.

Where is Revive Pharmacy Inc located?

Revive Pharmacy Inc is located at 16205 S Tamiami Trl Suite # 6, Fort Myers, FL 33908. The listed phone number is (239) 204-4223.

What is Revive Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Revive Pharmacy Inc enrolled in Medicare?

Yes. Revive Pharmacy Inc is registered in the Medicare PECOS enrollment system.

When is Revive Pharmacy Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Other) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Revive Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 49 other insurers list Revive Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Revive Pharmacy Inc was last updated on February 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.