Provider Demographics
NPI:1275385049
Name:MOBILE WOUND CARE OF FLORIDA
Entity Type:Organization
Organization Name:MOBILE WOUND CARE OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:239-823-8651
Mailing Address - Street 1:1851 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:FL
Mailing Address - Zip Code:33920-3444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1851 BROWN RD
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:FL
Practice Address - Zip Code:33920-3444
Practice Address - Country:US
Practice Address - Phone:239-823-8651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty