Fladjy Rivens Revolus

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40641 Issued in FL

Practice address

13800 Veterans Way
Orlando, FL 32827-7401

Phone

(407) 631-1000

NPI assigned

Dec 21, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Luna Care Physical Therapy LLCGroup PAC ID 3779991559, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1194594937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7698 LOWER GATEWAY LOOP UNIT 824",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277198",
            "telephone_number": "813-464-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 VETERANS WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277401",
            "telephone_number": "407-631-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVOLUS",
        "first_name": "FLADJY",
        "middle_name": "RIVENS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revival Home Support L.L.C
• Revive Transitional Care and in Home Primary Medicine, LLC
• Revive5 Pain Management LLC
• Revivecare Medical & Wellness LLC
• Revivify Beauty Salon & Spa, LLC
• Gita Rewari, DDS
• Stephannie Rey-Cubero, APRN
• Helen Reyes Diaz
• Arnaldo Enrique Reyes Esteves, MD
• Aroa Abigail Reyes Fernandez

• Physical Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.