Healthcare Provider Details

I. General information

NPI: 1053158352
Provider Name (Legal Business Name): FLORIDA WOUND CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6719 GALL BLVD STE 203
ZEPHYRHILLS FL
33542-2569
US

IV. Provider business mailing address

19933 TAMIAMI AVE
TAMPA FL
33647-3366
US

V. Phone/Fax

Practice location:
  • Phone: 813-957-8730
  • Fax: 813-212-2824
Mailing address:
  • Phone: 813-957-8730
  • Fax: 813-212-2824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARA LARSON HUSSAIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 813-957-8730