Revive Md Pllc
LBN: Revive Md Pllc
Revive Md Pllc is an health care organization with primary practice located at 821 Raymond Ave Ste 230 , Saint Paul MN 55114-1503. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is the primary health care specialty.
Revive Md Pllc can be contacted via phone (651) 746-4412, or through Morales, Alfonso via phone (651) 476-4412.
Contact Information
Primary practice address
821 Raymond Ave Ste 230
Saint Paul MN 55114-1503
Phone: (651) 746-4412
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | ||
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X |
Profile Details
| NPI number | 1346832953 |
|---|---|
| LBN Legal business name | Revive Md Pllc |
| DBA Doing business as | |
| Authorized official | Morales, Alfonso Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 4th, 2021 |
| Last updated | Feb 4th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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