Provider Demographics
NPI:1992496343
Name:VISION MOBILE WOUND CARE SERVICES, LLC
Entity type:Organization
Organization Name:VISION MOBILE WOUND CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, DIRECTOR OF CLINICAL OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,WCC
Authorized Official - Phone:877-281-1593
Mailing Address - Street 1:414 SW 140TH TER STE 170
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-5432
Mailing Address - Country:US
Mailing Address - Phone:877-281-1593
Mailing Address - Fax:352-354-1542
Practice Address - Street 1:414 SW 140TH TER STE 3300
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3363
Practice Address - Country:US
Practice Address - Phone:877-281-1593
Practice Address - Fax:352-354-1542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care