Healthcare Provider Details

I. General information

NPI: 1851234702
Provider Name (Legal Business Name): CORE WOUND CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 SELVA LAKES CIR
ATLANTIC BEACH FL
32233-4355
US

IV. Provider business mailing address

1015 ATLANTIC BLVD # 404
ATLANTIC BEACH FL
32233-3313
US

V. Phone/Fax

Practice location:
  • Phone: 904-290-3234
  • Fax:
Mailing address:
  • Phone: 904-290-3234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOHN COBB
Title or Position: OWNER
Credential: APRN
Phone: 904-290-3234