| Revitalizing Infusion Therapies, Llc | |
|
100 E Dakin Ave Kissimmee FL 34741-5724 | |
| (321) 442-0192 | |
| Not Available |
| Full Name | Revitalizing Infusion Therapies, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 E Dakin Ave, Kissimmee, Florida |
| Authorized Official Name and Position | Michael Craig Browning (OWNER) |
| Authorized Official Contact | 5733554158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalizing Infusion Therapies, Llc 100 E Dakin Ave Kissimmee FL 34741-5724 Ph: (321) 442-0192 | Revitalizing Infusion Therapies, Llc 100 E Dakin Ave Kissimmee FL 34741-5724 Ph: (321) 442-0192 |
| NPI Number | 1508485756 |
|---|---|
| Provider Enumeration Date | 04/08/2020 |
| Last Update Date | 11/09/2023 |
| Certification Date | 11/09/2023 |
| Medicare PECOS PAC ID | 6305236423 |
|---|---|
| Medicare Enrollment ID | O20211203002670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508485756 | NPI | - | NPPES |
| Provider Name | Rachel Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649267097 PECOS PAC ID: 7214970623 Enrollment ID: I20050607000540 |
| Provider Name | Agnes Tolentino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669589891 PECOS PAC ID: 4082649405 Enrollment ID: I20051004000662 |
| Provider Name | Ricardo Bernal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023087889 PECOS PAC ID: 0345343588 Enrollment ID: I20070308000647 |
| Provider Name | Christa H Sedney |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1598872384 PECOS PAC ID: 6204870751 Enrollment ID: I20081021000410 |
| Provider Name | Brent William Barrett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245209865 PECOS PAC ID: 6709868730 Enrollment ID: I20180125000087 |
| Provider Name | Michael Clifton Mcgowan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386914828 PECOS PAC ID: 8820259344 Enrollment ID: I20200730000322 |
| Provider Name | Michelle Attar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346867207 PECOS PAC ID: 2163848805 Enrollment ID: I20200812002575 |
| Provider Name | Jannia Mendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316457948 PECOS PAC ID: 1355754524 Enrollment ID: I20210107000241 |
| Provider Name | Caitlin Reilly Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225623291 PECOS PAC ID: 6901296615 Enrollment ID: I20211210001541 |
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