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REVIVAL HEALTH SERVICES LLC
NPI 1669165197
Family Medicine in Boca Raton, FL

Active since May 31, 2023
21065 POWERLINE RD STE 35, BOCA RATON, FL 33433(561) 484-2947 Get Directions Write a Review

NPPES record last updated: January 2, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 2, 2024, May 31, 2023 (2 updates tracked since 2023).

About Revival Health Services Llc NPPES

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

REVIVAL HEALTH SERVICES LLC (NPI 1669165197) is a healthcare organization registered as a family medicine in Boca Raton, Florida and active in the NPI registry since May 2023. The organization lists Camila Mendez, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1669165197
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREVIVAL HEALTH SERVICES LLC
Location Address21065 POWERLINE RD STE 35Boca Raton, FL 33433-2313
Mailing Address20980 Cipres WayBoca Raton, FL 33433-1604 · (646) 921-0872 · Fax (315) 612-9793
Phone(561) 484-2947
Organization SubpartNo
Authorized OfficialCamila MendezDirector Of Operations · (646) 921-0872
Enumeration DateMay 31, 2023
Last NPPES UpdateJanuary 2, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 2, 2024
✔ NPI 1669165197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

21065 POWERLINE RD STE 35, Boca Raton, FL 33433
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2308253

Revival Health Services LLC · Boca Raton, FL
Expired · Jul 23, 2026
CLIA Number10D2308253
Laboratory TypePhysician Office
Certificate Effective DateJuly 24, 2024
Certificate Expiration DateJuly 23, 2026
Laboratory DirectorAndrew Bennett
Laboratory Phone(646) 921-0872
Laboratory LocationRevival Health Services LLC21065 Powerline Rd Suite 35, Boca Raton, FL 33433
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Revival Health Services LLC's NPI number?

The NPI number for Revival Health Services LLC is 1669165197. It was assigned to this organization in the NPPES registry on May 31, 2023.

Where is Revival Health Services LLC located?

Revival Health Services LLC is located at 21065 Powerline Rd Ste 35, Boca Raton, FL 33433. The listed phone number is (561) 484-2947.

What is Revival Health Services LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Revival Health Services LLC was last updated on January 2, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.