| Wounddirect Partners, Llc | |
|
2706 Alt 19 Ste 250 Palm Harbor FL 34683-2655 | |
| (512) 640-5111 | |
| (512) 640-5115 |
| Full Name | Wounddirect Partners, Llc |
|---|---|
| Speciality | General Practice |
| Location | 2706 Alt 19 Ste 250, Palm Harbor, Florida |
| Authorized Official Name and Position | Kevin Marshall Pearce (MANAGER/PARTNER) |
| Authorized Official Contact | 2142329870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wounddirect Partners, Llc 2323 Allen St Dallas TX 75204-2609 Ph: (512) 640-5111 | Wounddirect Partners, Llc 2706 Alt 19 Ste 250 Palm Harbor FL 34683-2655 Ph: (512) 640-5111 |
| NPI Number | 1457117004 |
|---|---|
| Provider Enumeration Date | 02/22/2024 |
| Last Update Date | 05/16/2024 |
| Medicare PECOS PAC ID | 8426498999 |
|---|---|
| Medicare Enrollment ID | O20240501000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457117004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Gerardo Reyes |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194767954 PECOS PAC ID: 1153429576 Enrollment ID: I20220216000174 |
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