Revival Med Centers, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

REVIVAL MED CENTERS, LLC

Practice address

8353 SW 124TH St Ste 207a
Miami, FL 33156-5847

Phone

(786) 443-5833

NPI assigned

Sep 27, 2024

Organization subpart

No

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

Authorized official

Name

Rosa Alba PerezNPI 1821727132

Title

Owner

Phone

(561) 886-8459

Specialties & licenses 2

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.

• Rosa Alba Perez, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
  • NPI 1821727132

  Family

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1871311076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8353 SW 124TH ST STE 207A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565847",
            "telephone_number": "786-443-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8353 SW 124TH ST STE 207A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565847",
            "telephone_number": "786-443-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL MED CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-27",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "ALBA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-886-8459"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Revive Health Center, Inc.
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• Lesyani Anaisa Revolta Carrero
• Dominique Revolus

• Psychiatric/Mental Health Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.