OrganizationActive
Revan LLC
NPI 1730145673 · Undersea and Hyperbaric Medicine (Emergency Medicine) Physician · Palm Harbor, FL
Provider details
- NPI number
- 1730145673
- Entity type
- Organization
- Primary specialty
- Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Charles Boothby, Owner
- License
- OS4598 (FL)
Practice location
3890 Tampa Rd Ste 201
Palm Harbor, FL 34684-3677
Phone: (727) 781-3111
Fax: (727) 781-3113
Mailing address
Po Box 25513
Tampa, FL 33622-5513
Registry dates
- Enumerated
- 2006-04-20
- Last updated
- 2015-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.