Organization Active NPI

Revitalize Medical Center Naples, LLC

  • General Practice Physician
  • Naples, FL
National Provider Identifier
1962295410
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
REVITALIZE MEDICAL CENTER NAPLES, LLC
Practice address
5625 Strand Blvd Ste 501
Naples, FL 34110-7384
Phone
(786) 359-4999
Fax
(786) 359-4843
NPI assigned
May 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Mirtha Valdes
Title
Manager
Phone
(239) 443-8369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

5625 Strand Blvd Ste 501
Naples, FL 34110-7384

Mailing address

5625 Strand Blvd Ste 501
Naples, FL 34110-7384

National Provider Directory

National Provider Directory

Locations

5625 Strand Blvd
Ste 501
Naples, FL 34110
Phone (786) 359-4999

NPI Registry JSON

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": "1962295410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 STRAND BLVD STE 501",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341107384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 STRAND BLVD STE 501",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341107384",
            "telephone_number": "786-359-4999",
            "fax_number": "786-359-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE MEDICAL CENTER NAPLES, 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": "VALDES",
        "authorized_official_first_name": "MIRTHA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-443-8369"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • 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.