Revivify Dermatology, LLC

NPI #1699319988 in Boca Raton, Florida

Provider Information

NPI Number: 1699319988
Entity Type: Organization
Organization Name: Revivify Dermatology, LLC
Primary Specialty: Dermatology
Enumeration Date: Oct 30, 2019
Last Updated: Aug 19, 2020

Practice Location

Address: 21301 POWERLINE RD # 108
City: Boca Raton
State: Florida
ZIP Code: 33433-2388
Phone: (561) 877-8675

Authorized Official

Name: DENISE M. GUEVARA, DO
Title: MEDICAL DIRECTOR
Phone: (561) 877-8675

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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