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

Revitalize LLC

Organization Family Medicine Physician · NPI 1417238015

Revitalize LLC provides Family Medicine Physician services 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 Not confirmed with CMS for 14 years — call before visiting
Phone: (301) 330-9430
Fax: (301) 330-6515
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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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