Revitalize Medical Center Palmetto Bay, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

REVITALIZE MEDICAL CENTER PALMETTO BAY, LLC

Practice address

9245 SW 158TH LN Unit 201-202
Palmetto Bay, FL 33157-1804

Phone

(786) 701-9639

Fax

(786) 713-0179

NPI assigned

May 27, 2025

Last updated

May 27, 2025By 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

Dayana Revuelta

Title

Manager

Phone

(786) 701-9639

Specialties & licenses 1

Addresses

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.

• Niurka Izaguirre, APRN

  • Family Nurse Practitioner
  • Hialeah, FL
  • NPI 1750192084
  NPD (past)

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1437942992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9245 SW 158TH LN UNIT 201-202",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571804",
            "telephone_number": "786-701-9639",
            "fax_number": "786-713-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9245 SW 158TH LN UNIT 201-202",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571804",
            "telephone_number": "786-701-9639",
            "fax_number": "786-713-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE MEDICAL CENTER PALMETTO BAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "REVUELTA",
        "authorized_official_first_name": "DAYANA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-701-9639"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Palmetto Bay, FL
• Providers in Palmetto Bay, 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 May 27, 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.