Revuelta, Manuel

Revuelta, Manuel is an individual health care provider with primary practice located at 2780 Cleveland Ave Suite 809, Fort Myers FL 33901-5817. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Revuelta, Manuel can be contacted via phone (239) 343-9680.

Contact Information

Primary practice address
2780 Cleveland Ave Suite 809 Fort Myers FL 33901-5817
Phone: (239) 343-9680
Fax: (239) 343-9685
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 199820 New York
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 199820 New York

Profile Details

NPI number 1184606097
LBN Legal business name Revuelta, Manuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated May 28th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184606097 NPPES
New York MEDICAID 01620240

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