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General NPI Number Information
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NPI Number | 1710874391
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA WOUND AND DERM LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 2400 MAITLAND CENTER PKWY STE 310
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City | MAITLAND
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State | FL
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Zip | 32751-7442
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Country | US
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Telephone | 407-426-4800
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Fax | 407-426-4820
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Provider Business Mailing Address
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Address Line | 2400 MAITLAND CENTER PKWY STE 310
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City | MAITLAND
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State | FL
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Zip | 32751-7442
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KACIAN BROWN
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Credential | MD
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Telephone | 407-426-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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