| Advanced Wound Care Solution | |
|
3800 W Broward Blvd Ste 101 Fort Lauderdale FL 33312-1018 | |
| (804) 282-4181 | |
| (804) 288-4184 |
| Full Name | Advanced Wound Care Solution |
|---|---|
| Speciality | Clinic/Center |
| Location | 3800 W Broward Blvd Ste 101, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Al Berry (MANAGER) |
| Authorized Official Contact | 4699154211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Wound Care Solution 3800 W Broward Blvd Ste 101 Fort Lauderdale FL 33312-1018 Ph: (804) 282-4181 | Advanced Wound Care Solution 3800 W Broward Blvd Ste 101 Fort Lauderdale FL 33312-1018 Ph: (804) 282-4181 |
| NPI Number | 1518787902 |
|---|---|
| Provider Enumeration Date | 10/11/2024 |
| Last Update Date | 04/16/2025 |
| Certification Date | 04/16/2025 |
| Medicare PECOS PAC ID | 7214459718 |
|---|---|
| Medicare Enrollment ID | O20250313001920 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518787902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| 163WW0000X | Registered Nurse - Wound Care | () | Secondary |
| 213EP1101X | Podiatrist - Primary Podiatric Medicine | () | Secondary |
| Provider Name | Vikram Thakar |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952612996 PECOS PAC ID: 6002074796 Enrollment ID: I20130710000218 |
| Provider Name | Henry Odazie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740880848 PECOS PAC ID: 4688084296 Enrollment ID: I20201111001171 |
| Provider Name | Melissa Erskine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093501264 PECOS PAC ID: 3173004058 Enrollment ID: I20260227003395 |
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