Revitalize Clinics Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

REVITALIZE CLINICS INC

Practice address

860 NW 42ND Ave Ste 406
Miami, FL 33126-4176

Phone

(786) 636-8084

NPI assigned

Apr 24, 2025

Organization subpart

No

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

Authorized official

Name

Roberto Perdomo

Title

Owner

Phone

(305) 215-2999

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1215724067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 NW 42ND AVE STE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331264176",
            "telephone_number": "786-636-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 NW 42ND AVE STE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331264176",
            "telephone_number": "786-636-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "PERDOMO",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-215-2999"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lianne Revilla, APRN
• Revilbray Revilla, FNP-C
• Revised Perspective
• Revital Eyes PA
• Revitalize Care Center Inc
• Revival Med Centers, LLC
• Revival Orthopaedics Inc
• Revive Health Center, Inc.
• Revline Billing Solutions LLC
• Lesyani Anaisa Revolta Carrero

• General Practice Physician in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.