Mobile Wound Care Collaborative LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

MOBILE WOUND CARE COLLABORATIVE LLC

Practice address

13420 Parker Commons Blvd Ste 106
Fort Myers, FL 33912-1973

Phone

(321) 328-9458

NPI assigned

Jul 21, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vital Management Group LLC

Title

MGR

Phone

(321) 328-9458

Specialties & licenses 1

Addresses

Tax ID family

Mobile Wound Care Collaborative LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sunwave Woundcare

  • General Practice Physician
  • Delray Beach, FL
  • NPI 1518757178
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1093697112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13420 PARKER COMMONS BLVD STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13420 PARKER COMMONS BLVD STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121973",
            "telephone_number": "321-328-9458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE WOUND CARE COLLABORATIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-21",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "MANAGEMENT GROUP LLC",
        "authorized_official_first_name": "VITAL",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "321-328-9458"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan A Mizell, M.D.
• Deborah Jean Mizerak, MS CCC-SLP MBA
• MLC Behavior Care LLC
• Mobile Dental Care of Florida LLC
• Mobile Woc, LLC
• Mobility PT
• Bridget Modica
• Pawanard Modpradit, APRN
• Anna Moffitt
• Emily Ann Moffitt

• Primary Care Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.