Healthcare Provider Details

I. General information

NPI: 1407761695
Provider Name (Legal Business Name): OASIS ADVANCED WOUND SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

864 BRADDOCK RD
ENTERPRISE FL
32725-8703
US

IV. Provider business mailing address

864 BRADDOCK RD
ENTERPRISE FL
32725-8703
US

V. Phone/Fax

Practice location:
  • Phone: 386-327-2223
  • Fax:
Mailing address:
  • Phone: 386-327-2223
  • 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: LAURIE COLE
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential:
Phone: 386-327-2223