Healthcare Provider Details

I. General information

NPI: 1245056522
Provider Name (Legal Business Name): WOUND CARE PHYSICIANS OF TAMPA BAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 49TH ST N STE S104-B
ST PETERSBURG FL
33709-2146
US

IV. Provider business mailing address

5800 49TH ST N STE S104-B
ST PETERSBURG FL
33709-2146
US

V. Phone/Fax

Practice location:
  • Phone: 727-291-1637
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ALI SABERI
Title or Position: OWNER
Credential: MD
Phone: 727-291-1637