Revita Medical Center LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

REVITA MEDICAL CENTER LLC

Practice address

724 S Krome Ave
Homestead, FL 33030-7264

Phone

(786) 922-6393

NPI assigned

Sep 9, 2024

Organization subpart

No

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

Authorized official

Name

Diego Ferreira

Title

Manager

Phone

(786) 339-8248

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alfredo Portal Garcia

  • Family Medicine Physician
  • Miami, FL
  • NPI 1700623048
  Medicare reassignment NPD

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

{
    "created_epoch": "1725840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763942400000",
    "number": "1811723869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 S KROME AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330307264",
            "telephone_number": "786-339-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S KROME AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330307264",
            "telephone_number": "786-922-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITA MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-09",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A",
        "authorized_official_last_name": "FERREIRA",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-339-8248"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Homestead, FL
• Providers in Homestead, FL by specialty
• Adult Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.