D/B/A Wound Management

LBN: Revan Llc
D/B/A Wound Management is an health care organization with primary practice located at 3890 Tampa Rd Ste 201 , Palm Harbor FL 34684-3677. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, which is considered as the primary health care specialty. Revan Llc can be contacted via phone (727) 781-3111, or through Boothby, Charles via phone (727) 869-5551.

Contact Information

Primary practice address
3890 Tampa Rd Ste 201 Palm Harbor FL 34684-3677
Phone: (727) 781-3111
Fax: (727) 781-3113
Website:
Map and Directions
Authorized official contact:
Name: Boothby, Charles Doctor of Osteopathy (DO)
Phone: (727) 869-5551

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 207PE0005X OS4598 Florida

Profile Details

NPI number 1730145673
LBN Legal business name Revan Llc
DBA Doing business as D/B/A Wound Management
Authorized official Boothby, Charles Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 20th, 2006
Last updated Jul 1st, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730145673 NPPES
Florida MEDICAID 069165800
Florida Other 82569

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