MEDICARE: WOUND TECHNOLOGY NETWORK INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962601393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND TECHNOLOGY NETWORK INC

Provider Business Mailing Address
First Line	:	PO BOX 931967
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-1967
Country	:	US
Telephone Number	:	954-923-7440
Fax Number	:	954-923-1299

Provider Business Practice Location Address
First Line	:	5979 VINELAND RD STE 109
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7857
Country	:	US
Telephone Number	:	954-923-7440
Fax Number	:	954-923-1299

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	MINGHSUN LIU
Credential	:	MD
Telephone Number	:	310-734-8526

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	12/16/2025

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