| NPI | 1689467136 |
|---|---|
| Doing Business As | REVITALIZE HEALTH CARE CENTER OF FORT MYERS |
| Entity Type | Organization |
| Authorized Contact | MEIVYS E AVILA CASTRO Manager 239-291-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-08-29 |