REVELATION FAMILY MEDICINE OFFICE, LLC. (NPI# 1912472200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912472200 |
| Entity Type | Organization |
| Organization Name | REVELATION FAMILY MEDICINE OFFICE, LLC. |
| Practice Address |
3939 Hollywood Blvd Ste 300b Hollywood FL 33021-6749 |
| Practice Telephone | 7868638633 |
| Mailing Telephone | 7868638633 |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2018-10-12 |
| Authorized Official Name | MR. JEAN-MARCEL FORTE (CERTIFIED PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 3058074283 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
3939 HOLLYWOOD BLVD STE 300B |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-6749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558326678 | Evelyn Helene Sinclair | Family Medicine | 4720 Pierce St, Hollywood, FL 33021-5808 | 2006-04-20 |
| 1134120827 | Omar Jose Brito | Family Medicine | 6517 Taft St, Suite 2007, Hollywood, FL 33024-4048 | 2005-08-03 |
| 1780176032 | Paz Alvarez LLC | Family Medicine | 9700 Stirling Rd Ste 107, Hollywood, FL 33024-8011 | 2018-06-02 |
| 1356638381 | Orlando H Espinoza | Family Medicine | 3100 Stirling Rd, Suite A, Hollywood, FL 33021-2040 | 2011-06-28 |
| 1841232519 | Dr Harry Pepe and Associates Inc | Family Medicine | 4510 Sheridan St, Hollywood, FL 33021-3516 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598105 | Foundations Medical Center Pllc | Family Medicine | 4467 Commons Dr W Ste F-g, Destin, FL 32541-8454 | 2020-11-04 |
| 1831704345 | Vasundhara Kuchibhotla | Family Medicine | 1630 Sw 75th Ter, Gainesville, FL 32607-6604 | 2020-09-11 |
| 1356952170 | Discreet Health Solutions, LLC | Family Medicine | 7124 Pelican Island Dr, Tampa, FL 33634-7463 | 2020-08-14 |
| 1033728019 | Nana Aisha Garba | Family Medicine | 11200 Sw 8th St Ahc2 Rm 589b, Miami, FL 33199-0001 | 2020-07-27 |
| 1043838451 | Lisa M Parker | Family Medicine | 7955 Bay St Ste 2, Sebastian, FL 32958-3282 | 2020-07-13 |
| 1699390336 | Rosenie B Jasmin | Family Medicine | Dove Medical Centers, LLC, 2901 West Oakland Park Blvd Ste A4-5, Oakland Park, FL 33311 | 2020-06-09 |
| 1588287239 | Sarai L Gonzalez | Family Medicine | 16182 Nw 21st St, Pembroke Pines, FL 33028-1255 | 2020-05-28 |
| 1184247033 | Wellness Solutions 2020 LLC | Family Medicine | 2300 N Commerce Pkwy Ste 321, Weston, FL 33326-3257 | 2020-05-27 |
| 1780207910 | Homeville Medical Care | Family Medicine | 11040 Nw 18th Ct, Plantation, FL 33322-3407 | 2020-05-21 |
| 1942829536 | Health Medical Ultra Limited Liability Company | Family Medicine | 1760 Havendale Blvd Nw, Winter Haven, FL 33881-1224 | 2020-04-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.