Revan LLC
NPI #1730145673 in Palm Harbor, Florida
Provider Information
- NPI Number
- 1730145673
- Entity Type
- Organization
- Organization Name
- Revan LLC
- Primary Specialty
- Emergency Medicine - Undersea and Hyperbaric Medicine
- Enumeration Date
- Apr 20, 2006
- Last Updated
- Jul 1, 2015
Practice Location
- Address
- 3890 TAMPA RD STE 201
- City
- Palm Harbor
- State
- Florida
- ZIP Code
- 34684-3677
- Phone
- (727) 781-3111
Authorized Official
- Name
- CHARLES BOOTHBY, D.O.
- Title
- OWNER
- Phone
- (727) 869-5551
Specialties & Taxonomy Codes
| Specialty |
|---|
| Emergency Medicine - Undersea and Hyperbaric Medicine — Undersea and Hyperbaric Medicine |
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