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Diana Revenco, MD
Cardiovascular Disease Physician in Tampa, Florida
NPI 1386810091

Diana Revenco is a Cardiovascular Disease Physician based in Seattle, FL and is specialized in Cardiovascular Disease. Diana Revenco practices in Tampa, FL and has the professional credentials of MD. The NPI Number for Diana Revenco is 1386810091 and holds a License No. 15634 (Florida).

The current practice location address for Diana Revenco is 6919 N Dale Mabry Hwy Ste 125, Tampa, FL and can be reached out via phone at 813-497-9661 and via fax at 813-615-8468. You can also correspond with Diana Revenco through the mailing address at 1100 9TH AVE, SEATTLE, WA - 98101-2756 (mailing address contact number: 206-515-5811).

Location: 6919 N Dale Mabry Hwy Ste 125, Tampa, FL, 98101-2756
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386810091
Provider Name
Diana Revenco
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
6919 N Dale Mabry Hwy Ste 125, Tampa, FL, 98101-2756
Phone Number
813-497-9661
Fax Number
813-615-8468
Provider Enumeration Date
05/02/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P01138997 01 NH RR MEDICARE
3075998 05 NH
1386810091 05 ME
institution
Provider Business Practice Location Address Details
Address
6919 N Dale Mabry Hwy Ste 125
City
Tampa
State
Florida
Zip
33614-3972
Phone Number
813-497-9661
Fax Number
813-615-8468
person
Provider Business Mailing Address Details
Address
1100 9Th Ave
City
Seattle
State
Washington
Zip
98101-2756
Phone Number
206-515-5811
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
207RC0000X
License No.
MD60668587 (Washington)
Definition
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.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Nuclear Medicine
Speciality
Nuclear Cardiology
Taxonomy
207UN0901X
License No.
15634 (New Hampshire)
Definition
A nuclear medicine physician who specializes in nuclear cardiology.
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