Healthcare Provider Details

I. General information

NPI: 1245262831
Provider Name (Legal Business Name): DELAWARE VALLEY WOUND CARE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 LANCASTER AVE
DEVON PA
19333-1316
US

IV. Provider business mailing address

860 LANCASTER AVE
DEVON PA
19333-1316
US

V. Phone/Fax

Practice location:
  • Phone: 610-687-1400
  • Fax: 610-687-1065
Mailing address:
  • Phone: 610-687-1400
  • Fax: 610-687-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberSC004682L
License Number StatePA

VIII. Authorized Official

Name: DR. ROBERT C FLOROS
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 610-316-6611