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General NPI Number Information
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NPI Number | 1740079136
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Entity Type | Organization
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Legal Business Name | PHYSICIANS WOUND TREATMENT OF TAMPA INC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 15511 N FLORIDA AVE STE A1-A2
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City | TAMPA
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State | FL
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Zip | 33613-1263
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Country | US
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Telephone | 813-753-6899
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Fax |
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Provider Business Mailing Address
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Address Line | 15515 N FLORIDA AVE # 101-102
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City | TAMPA
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State | FL
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Zip | 33613-1232
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Country | US
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Telephone | 813-753-6899
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANJIV RAO
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Credential | DO
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Telephone | 813-753-6899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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