Provider Demographics
NPI:1770718561
Name:FLORIDA WOUND CARE INC
Entity type:Organization
Organization Name:FLORIDA WOUND CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAYYED
Authorized Official - Middle Name:T
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-388-6838
Mailing Address - Street 1:10335 CROSS CREEK BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2764
Mailing Address - Country:US
Mailing Address - Phone:813-388-6838
Mailing Address - Fax:813-388-9526
Practice Address - Street 1:10335 CROSS CREEK BLVD STE 20
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2764
Practice Address - Country:US
Practice Address - Phone:813-388-6838
Practice Address - Fax:813-388-9526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85377207RH0002X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCE617AOtherMEDICARE