Provider Demographics
NPI:1831282342
Name:NATIONAL WOUND CARE PHYSICIANS INC
Entity Type:Organization
Organization Name:NATIONAL WOUND CARE PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTILLENTI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-584-7666
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34697-0752
Mailing Address - Country:US
Mailing Address - Phone:727-584-7666
Mailing Address - Fax:727-586-1386
Practice Address - Street 1:2039 INDIAN ROCKS ROAD S
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774
Practice Address - Country:US
Practice Address - Phone:727-584-7666
Practice Address - Fax:727-586-1386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77706OtherBCBS OF FLORIDA