FL Wound Care Medical Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FL WOUND CARE MEDICAL GROUP

Practice address

4728 N Habana Ave Ste 203
Tampa, FL 33614-7147

Phone

(323) 480-4075

NPI assigned

Oct 27, 2022

Last updated

Oct 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Owen Bernardo Ellington, MDNPI 1396703310

Title

President

Phone

(713) 304-4227

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Owen Bernardo Ellington, M.D, J.D.

  • Hematology & Oncology Physician
  • Humble, TX
  • NPI 1396703310
  Authorized official Same address or phone

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1760109003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W CENTURY BLVD STE 750",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455443",
            "telephone_number": "323-480-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4728 N HABANA AVE STE 203",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147147",
            "telephone_number": "323-480-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FL WOUND CARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "ELLINGTON",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "BERNARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-304-4227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• FL-I Medical Services LLC
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• FL-I Medical Services, LLC
• Rachel Marie Flack, PA-C
• Emily Flaherty, LMHC

• General Practice Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.