Healthcare Provider Details

I. General information

NPI: 1619825049
Provider Name (Legal Business Name): WOUND WISE HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6709 RIDGE RD STE 104A
PORT RICHEY FL
34668-6851
US

IV. Provider business mailing address

6709 RIDGE RD STE 104A
PORT RICHEY FL
34668-6851
US

V. Phone/Fax

Practice location:
  • Phone: 727-842-5462
  • Fax: 727-842-7145
Mailing address:
  • Phone: 727-842-5462
  • Fax: 727-842-7145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NELLY ELLA CHOUDJA
Title or Position: OWNER/PROVIDER
Credential: APRN
Phone: 614-556-5920