Revel Physical Therapy and Wellness, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVEL PHYSICAL THERAPY AND WELLNESS, LLC

Practice address

500 Harbour Place Dr Apt 1313
Tampa, FL 33602-6745

Phone

(603) 387-2357

NPI assigned

Jun 13, 2022

Organization subpart

No

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

Authorized official

Name

Justine N Fournier, PT, DPT

Title

Physical Therapist

Phone

(603) 387-2357

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1902536071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HARBOUR PLACE DR APT 1313",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336026745",
            "telephone_number": "603-387-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARBOUR PLACE DR APT 1313",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336026745",
            "telephone_number": "603-387-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVEL PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "FOURNIER",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "603-387-2357",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Revision Therapy
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• Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.