Revivalife Health PLLC
NPI 1255130621ActiveOrganization· Nurse Practitioner, Family· Deland, FL
Nurse Practitioner, Family in Deland, Florida, registered in NPPES in March 2025. The authorized official on file is Emily Hidalgo, Managing Member. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1255130621 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 10, 2025 |
| Last updated in NPPES | May 5, 2026 |
| Certified by provider | May 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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