Provider Demographics
NPI:1235924358
Name:DIVERSIFIED REVENUE SOLUTIONS, LLC
Entity type:Organization
Organization Name:DIVERSIFIED REVENUE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ACEY
Authorized Official - Last Name:HEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-565-6308
Mailing Address - Street 1:13921 LAKE MAHOGANY BLVD APT 2824
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-6619
Mailing Address - Country:US
Mailing Address - Phone:239-565-6308
Mailing Address - Fax:239-244-8995
Practice Address - Street 1:13921 LAKE MAHOGANY BLVD APT 2824
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-6619
Practice Address - Country:US
Practice Address - Phone:239-565-6308
Practice Address - Fax:239-244-8995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty