DIANA REVENCO MD NPI 1386810091

NPI Information

NPI: 1386810091
Provider Name: DIANA REVENCO, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
6919 N DALE MABRY HWY STE 125
TAMPA, FL
ZIP 33614
Phone: (813) 497-9661
Get Directions

Diana Revenco, MD is a cardiovascular disease internal medicine in Tampa, FL with 21 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Diana Revenco, MD NPI is 1386810091. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6919 N DALE MABRY HWY STE 125
TAMPA, FL
ZIP 33614-972
Phone: (813) 497-9661
Fax: (813) 615-8468

The NPI 1386810091 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/2/2008 and was last updated on 9/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207UN0901X	Nuclear Medicine	Nuclear Cardiology	15634	NEW HAMPSHIRE	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	MD60668587	WASHINGTON	No
3	207RC0000X	Internal Medicine	Cardiovascular Disease	ME146373	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P01138997	OTHER	NEW HAMPSHIRE	RR MEDICARE
2	3075998	MEDICAID	NEW HAMPSHIRE
3	1386810091	MEDICAID	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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