| Central Florida Wound and Derm LLC | |
|
2400 Maitland Center Pkwy Ste 310 Maitland FL 32751-7442 | |
| (407) 426-4800 | |
| (407) 426-4820 |
| Full Name | Central Florida Wound and Derm LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 2400 Maitland Center Pkwy Ste 310, Maitland, Florida |
| Authorized Official Name and Position | Kacian Brown (OWNER) |
| Authorized Official Contact | 4074264800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Florida Wound and Derm LLC 2400 Maitland Center Pkwy Ste 310 Maitland FL 32751-7442 | Central Florida Wound and Derm LLC 2400 Maitland Center Pkwy Ste 310 Maitland FL 32751-7442 Ph: (407) 426-4800 |
| NPI Number | 1710874391 |
|---|---|
| Provider Enumeration Date | 06/18/2025 |
| Last Update Date | 07/24/2025 |
| Certification Date | 07/24/2025 |
| Medicare PECOS PAC ID | 7315445269 |
|---|---|
| Medicare Enrollment ID | O20250810000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710874391 | NPI | - | NPPES |
| Provider Name | Dorothy L Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518075407 PECOS PAC ID: 5294823852 Enrollment ID: I20071114000577 |
| Provider Name | Kacian Simone Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508029141 PECOS PAC ID: 2466590492 Enrollment ID: I20101020001257 |
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