Revive Medical Spa LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVIVE MEDICAL SPA LLC

Practice address

2150 49TH St N
St Petersburg, FL 33710-5237

Phone

(727) 321-6130

NPI assigned

Jan 5, 2015

Last updated

Jan 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Bretz, D.C.NPI 1124128319

Title

Practice Owner & Provider

Phone

(941) 921-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher N Bretz, D.C.

  • Chiropractor
  • Sarasota, FL
  • NPI 1124128319
  Authorized official Same address or phone

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1326436049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5989 APPROACH RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385720",
            "telephone_number": "941-921-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 49TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105237",
            "telephone_number": "727-321-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE MEDICAL SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "BRETZ",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRACTICE OWNER & PROVIDER",
        "authorized_official_telephone_number": "941-921-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AV987A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Restoration Family Chiropractic
• Restoration Psychiatry Services LLC
• Retreat European Esthetics PL
• Ross Revella, DC
• Revenant International LTD Co (Revenant International LLC)
• Francisco Jesus Rey, M.D.
• Dannaly Reyes Baerga, M.D.
• Carlos E Reyes, M.D.
• Josephine Reyes
• Steven Reyes, PA

• Chiropractor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.