Revive Health Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVIVE HEALTH CENTER, INC.

Practice address

1011 Ives Dairy Rd Ste 107
Miami, FL 33179-2536

Phone

(305) 709-4538

Fax

(305) 709-4548

NPI assigned

Aug 16, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sagi Shaked

Title

Owner

Phone

(305) 790-5037

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1003462862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 IVES DAIRY RD STE 105",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331792536",
            "telephone_number": "305-709-4538",
            "fax_number": "305-709-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 IVES DAIRY RD STE 107",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331792536",
            "telephone_number": "305-709-4538",
            "fax_number": "305-709-4548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4101 NW 3rd Ct Ste 17",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333172857",
            "country_code": "US",
            "telephone_number": "954-669-1996",
            "fax_number": "954-669-1997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7600 W 20th Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330161895",
            "country_code": "US",
            "telephone_number": "305-998-6967",
            "fax_number": "305-998-6997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 SW 12th Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330693298",
            "country_code": "US",
            "telephone_number": "954-908-2688",
            "fax_number": "954-908-2687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "SHAKED",
        "authorized_official_first_name": "SAGI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-790-5037"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELF PAY",
            "identifier": "1011",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.OFFICEALLY.COM",
            "affiliation": "N",
            "endpointDescription": "OFFICE ALLY",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMAIL",
            "address_1": "1011 Ives Dairy Rd Ste 107",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331792536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.