Revive Genetics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

REVIVE GENETICS LLC

Practice address

9000 SW 152ND St Ste 107
Palmetto Bay, FL 33157-1941

Phone

(786) 250-3419

Fax

(786) 250-3079

NPI assigned

Feb 21, 2026

Organization subpart

No

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

Authorized official

Name

Farzaneh Modarresi, PRESIDENT

Title

Owner

Phone

(786) 250-3419

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1771632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771632000000",
    "number": "1083568703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 SW 152ND ST STE 107",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571941",
            "telephone_number": "786-250-3419",
            "fax_number": "786-250-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SW 152ND ST STE 107",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571941",
            "telephone_number": "786-250-3419",
            "fax_number": "786-250-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE GENETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-21",
        "last_updated": "2026-02-21",
        "certification_date": "2026-02-21",
        "status": "A",
        "authorized_official_last_name": "MODARRESI",
        "authorized_official_first_name": "FARZANEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-250-3419",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Palmetto Bay, FL
• Providers in Palmetto Bay, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2026; 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.