MEDICARE: HEALNEXXT WOUNDCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1942013032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALNEXXT WOUNDCARE LLC

Provider Business Mailing Address
First Line	:	211 E MAIN ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4628
Country	:	US
Telephone Number	:	863-860-8093
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 E MAIN ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33801-4628
Country	:	US
Telephone Number	:	863-860-8093
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JULIA THRASHER
Credential	:
Telephone Number	:	863-860-8093

Provider Enumeration Date	:	01/31/2025
Last Update Date	:	01/31/2025

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