| Fl Wound Care Medical Group | |
|
4728 N Habana Ave Ste 203 Tampa FL 33614-7147 | |
| (323) 480-4075 | |
| Not Available |
| Full Name | Fl Wound Care Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 4728 N Habana Ave Ste 203, Tampa, Florida |
| Authorized Official Name and Position | Owen Bernardo Ellington (PRESIDENT) |
| Authorized Official Contact | 7133044227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fl Wound Care Medical Group 5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 Ph: (323) 480-4075 | Fl Wound Care Medical Group 4728 N Habana Ave Ste 203 Tampa FL 33614-7147 Ph: (323) 480-4075 |
| NPI Number | 1760109003 |
|---|---|
| Provider Enumeration Date | 10/27/2022 |
| Last Update Date | 10/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760109003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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