IV League Hydration Therapy LLC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Legal business name

IV LEAGUE HYDRATION THERAPY LLC

Doing business as

revIVe Hydration Therapy & Wellness

Practice address

2122 S Dale Mabry Hwy
Tampa, FL 33629-6312

Phone

(813) 769-9127

NPI assigned

Jul 5, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Sidney Bradley

Title

Ceo

Phone

(813) 769-9127

Specialties & licenses 1

Addresses

Other names 1

• revIVe Hydration Therapy & Wellness Doing business as

Locations

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1811620016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 W JETTON AVE STE A1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295115",
            "telephone_number": "813-769-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 S DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336296312",
            "telephone_number": "813-769-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IV LEAGUE HYDRATION THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-769-9127",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "revIVe Hydration Therapy & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Joy R Iurato, CPO/L
• Bogdan Konstantinov Ivanov, D.M.D.
• Simona Ivanov, DDS
• Stanislav Asenov Ivanov, MD
• Joyce Iverson, SLP
• Vannessa Ivery, PSY.S.

• Health & Wellness Coach in Tampa, FL
• Providers in Tampa, FL by specialty
• Health & Wellness Coach in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.