Provider Demographics
NPI:1710465679
Name:WOUND CARE PROS LLC
Entity Type:Organization
Organization Name:WOUND CARE PROS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOURA
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:407-388-8866
Mailing Address - Street 1:1180 SPRING CENTRE SOUTH BLVD STE 225
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-1991
Mailing Address - Country:US
Mailing Address - Phone:407-212-8431
Mailing Address - Fax:407-386-7878
Practice Address - Street 1:1180 SPRING CENTRE SOUTH BLVD STE 225
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-1991
Practice Address - Country:US
Practice Address - Phone:407-212-8431
Practice Address - Fax:407-386-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-02
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty