# MOBILE WOUND CARE COLLABORATIVE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093697112
- **Authorized official:** VITAL MANAGEMENT GROUP LLC (MGR)
- **Authorized official phone:** (321) 328-9458

## Contact information

- **Practice address:** 13420 PARKER COMMONS BLVD STE 106, FORT MYERS, FL 33912-1973
- **Practice address phone:** (321) 328-9458
- **Mailing address:** 13420 PARKER COMMONS BLVD STE 106, FORT MYERS, FL 33912-1973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2025
- **Last updated:** 07/21/2025