# AETHERUS WOUND AND LYMPHATICS PLLC

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

## Provider details

- **NPI number:** 1770413445
- **Authorized official:** LOAN LAM MD (OWNER)
- **Authorized official phone:** (813) 212-6517

## Contact information

- **Practice address:** 15310 AMBERLY DR STE 195, TAMPA, FL 33647-1646
- **Practice address phone:** (813) 212-6517
- **Mailing address:** 15303 AMBERLY DR STE C, TAMPA, FL 33647-2308
- **Mailing address phone:** (813) 212-6517
- **Mailing address fax:** (813) 212-6518

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WW0000X | Wound Care Registered Nurse | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2026
- **Last updated:** 06/23/2026