OrganizationActive
Revive MD PLLC
NPI 1346832953 · Interventional Pain Medicine Physician · Saint Paul, MN
Provider details
- NPI number
- 1346832953
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Alfonso Morales, Owner(651) 476-4412
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Ambulatory Health Care Facilities
Practice location
821 Raymond Ave Ste 230
Saint Paul, MN 55114-1503
Phone: (651) 746-4412
Approximate (ZIP-level) locationGet directions
Mailing address
7595 Currell Blvd Unit 25404
Woodbury, MN 55125-2569
Registry dates
- Enumerated
- 2021-02-04
- Last updated
- 2021-02-04
- Certified
- 2021-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.