Provider Demographics
NPI:1558404400
Name:SOPHOS INVESTMENTS LLC
Entity Type:Organization
Organization Name:SOPHOS INVESTMENTS LLC
Other - Org Name:WOUND MANAGEMENT ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BABALOLA
Authorized Official - Middle Name:OLUSOLA
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-300-4035
Mailing Address - Street 1:8875 HIDDEN RIVER PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33637-1035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8875 HIDDEN RIVER PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-1035
Practice Address - Country:US
Practice Address - Phone:813-300-4035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 74212208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI35274Medicare UPIN