Provider Demographics
NPI:1053158352
Name:FLORIDA WOUND CARE INC
Entity type:Organization
Organization Name:FLORIDA WOUND CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-388-6838
Mailing Address - Street 1:10335 CROSS CREEK BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2764
Mailing Address - Country:US
Mailing Address - Phone:813-388-6838
Mailing Address - Fax:813-388-9526
Practice Address - Street 1:6719 GALL BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-2569
Practice Address - Country:US
Practice Address - Phone:813-388-6838
Practice Address - Fax:813-388-9526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center