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Contact Information

WOUND AND MEDICAL OUTREACH CLINIC LLC
12250 BLUE PACIFIC DR
RIVERVIEW, FL33579-1803
 Phone: 813-777-1591
 Fax: 800-351-2611
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for WOUND AND MEDICAL OUTREACH CLINIC LLC · (Female)

NPI Number 1881229532
Status Active
Credentials
Entity Individual
Enumeration date 03/03/2020
Last updated 11/27/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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