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Revitalize LLC

Internal Medicine Physician in Rockville, MD · enumerated 2011 · authorized official Norton Fishman, Medical Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1417238015

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Registry record

Entity type Organization (Type 2)
Legal business name Revitalize LLC
Other name <Unavail>
Practice address 15235 Shady Grove Rd, Suite 102, Rockville, MD, 20850
Phone (301) 330-9430
Fax (301) 330-6515
Enumeration date Sep 9, 2011
Last updated in NPPES Oct 24, 2011

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License H67624 (MD) Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians · License D0050126 (MD) Primary

Authorized official

Name Norton Fishman
Title Medical Director
Phone (301) 330-9430

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Revitalize LLC?
NPPES lists Norton Fishman (Medical Director) as the authorized official for this organization.
What is the NPI number for Revitalize LLC?
The NPI for Revitalize LLC is 1417238015, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-10-24.