Healthcare Provider Details

I. General information

NPI: 1295658391
Provider Name (Legal Business Name): HEALIX ADVANCED WOUND CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988 HILL FLOWER DR
BROOKSVILLE FL
34604
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 813-240-1218
  • Fax:
Mailing address:
  • Phone: 813-240-1218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MAYRA ALEJANDRA RENDEROS
Title or Position: OWNER/WOUND CARE PROVIDER
Credential: APRN
Phone: 813-240-1218