MEDICARE: PRECISION WOUND CARE OF FLORIDA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WW0000X	Wound Care Registered Nurse
2	225X00000X	Occupational Therapist
3	225100000X	Physical Therapist
4	225200000X	Physical Therapy Assistant
5	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1457177222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION WOUND CARE OF FLORIDA LLC

Provider Business Mailing Address
First Line	:	6816 S SPARKMAN ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33616-2525
Country	:	US
Telephone Number	:	386-290-6317
Fax Number	:

Provider Business Practice Location Address
First Line	:	6816 S SPARKMAN ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33616-2525
Country	:	US
Telephone Number	:	386-290-6317
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HERMAN C SALLEY
Credential	:
Telephone Number	:	386-290-6317

Provider Enumeration Date	:	11/26/2024
Last Update Date	:	01/07/2026

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