Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revitalize LLC

Organization Family Medicine Physician · NPI 1417238015

Revitalize LLC is a Family Medicine Physician in Rockville, Maryland. Licensed in Maryland. Registered with an NPI since 2011.

Licensed in
MD
In the registry since
2011
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

15235 Shady Grove Rd Ste 102
Rockville, MD 20850-3234
Phone: (301) 330-9430
Fax: (301) 330-6515
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence D0050126 (MD)
Family Medicine Physician Taxonomy 207Q00000X · Licence H67624 (MD)

Record details

NPI number1417238015
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Norton Fishman — Medical Director · (301) 330-9430
Other names Optimal Health Physicians
NPI enumeratedSeptember 9, 2011
Last updated in NPPESOctober 24, 2011
Mailing address15235 Shady Grove Rd, Suite 102, Rockville, MD 20850-3234

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