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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

REVITALIZE HEALTH CENTER LLC
NPI 1689467136
General Practice in Fort Myers, FL

Active since May 27, 2025
5285 SUMMERLIN RD STE 101, FORT MYERS, FL 33919(239) 291-6633(239) 385-0644 Get Directions Write a Review

NPPES record last updated: October 16, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 16, 2026, May 27, 2025 (2 updates tracked since 2025).

About Revitalize Health Center Llc NPPES

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

REVITALIZE HEALTH CENTER LLC (NPI 1689467136), doing business as Revitalize Health Care Center Of Fort Myers, is a healthcare organization registered as a general practice in Fort Myers, Florida and active in the NPI registry since May 2025. The organization lists Meivys E Avila Castro, Manager, as its authorized official.

NPPES Registry Identity

NPI1689467136
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameREVITALIZE HEALTH CENTER LLC
Location Address5285 SUMMERLIN RD STE 101Fort Myers, FL 33919-7601
Mailing Address5285 Summerlin Rd Ste 101Fort Myers, FL 33919-7601 · (239) 688-6686 · Fax (239) 688-6671
Phone(239) 291-6633
Fax(239) 385-0644
Organization SubpartNo
Authorized OfficialMeivys E Avila CastroManager · (239) 291-6633
Enumeration DateMay 27, 2025
Last NPPES UpdateOctober 16, 20262 updates tracked since enumeration
NPPES CertifiedOctober 16, 2026
✔ NPI 1689467136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
5285 SUMMERLIN RD STE 101, Fort Myers, FL 33919
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Other Names 1

Doing Business AsRevitalize Health Care Center Of Fort Myers

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revitalize Health Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Revitalize Health Center LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Darvis Dager Lissabet, MD
General Practice
NPI 1720765506
2301 DEL PRADO BLVD S STE 890
Cape Coral, FL 33990
(239) 574-8880
✔ PECOS✔ Accepts Medicare4.3 mi
Jose Mantilla, APRN, FNP-C
Nurse Practitioner
NPI 1184511081
1530 LEE BLVD STE 1300
Lehigh Acres, FL 33936
(239) 674-9377
✔ PECOS14 mi
Rene Perez Garcia, APRN
Nurse Practitioner
NPI 1427765544
1154 LEE BLVD STE 4
Lehigh Acres, FL 33936
(239) 688-0033
✔ PECOS✔ Accepts Medicare15 mi
Vikti Gosalia, M.D.
Internal Medicine
NPI 1952537680
21297 OLEAN BLVD STE A
Port Charlotte, FL 33952
(855) 979-5700
✔ PECOS✔ Accepts Medicare31 mi
Jose Chavez, PMHNP-BC, AGACNP-BC
Nurse Practitioner
NPI 1043026008
11401 NW 29TH PL
Sunrise, FL 33323
(305) 799-6552
✔ PECOS102 mi
Christopher Blaisdell, D.O.
Osteopathic Manipulative Medicine
NPI 1013212331
1435 W 49TH PL
Hialeah, FL 33012
(305) 558-2500
✔ PECOS✔ Accepts Medicare109 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 Revitalize Health Center LLC's NPI number?

The NPI number for Revitalize Health Center LLC is 1689467136. It was assigned to this organization in the NPPES registry on May 27, 2025. The provider is doing business as Revitalize Health Care Center of Fort Myers.

Where is Revitalize Health Center LLC located?

Revitalize Health Center LLC is located at 5285 Summerlin Rd Ste 101, Fort Myers, FL 33919. The listed phone number is (239) 291-6633.

What is Revitalize Health Center LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Revitalize Health Center LLC enrolled in Medicare?

Yes. Revitalize Health Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revitalize Health Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 4 Medicare specialties reassign their Medicare billing to Revitalize Health Center 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. The largest specialties are Nurse Practitioner (3), General Practice (1) and Internal Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Revitalize Health Center LLC was last updated on October 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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.