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General NPI Number Information
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NPI Number | 1417050824
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA WOUND & SKIN CONSULTANTS,INC.
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 14325 BENDING BRANCH CT
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City | ORLANDO
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State | FL
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Zip | 32824
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Country | US
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Telephone | 407-359-6426
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Fax | 407-359-6426
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Provider Business Mailing Address
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Address Line | PO BOX 607521
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City | ORLANDO
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State | FL
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Zip | 32860-7521
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Country | US
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Telephone | 407-359-6426
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Fax | 407-359-6426
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MS. MARY T FIKERT
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Credential |
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Telephone | 407-342-4384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 3110002150
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License Number State | FL
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