Healthcare Provider Details

I. General information

NPI: 1316819832
Provider Name (Legal Business Name): EVERHEALTH WOUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 CITRUS MEDICAL CT
OCOEE FL
34761-4548
US

IV. Provider business mailing address

1530 CITRUS MEDICAL CT
OCOEE FL
34761-4548
US

V. Phone/Fax

Practice location:
  • Phone: 337-315-7927
  • Fax:
Mailing address:
  • Phone: 337-315-7927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TYLER STOUT
Title or Position: OFFICE MANAGER
Credential:
Phone: 337-315-7927