Organization
AETHERUS WOUND AND LYMPHATICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOAN LAM MD (OWNER)
(813) 212-6517
Entity
Organization
Contact information
Practice address
15310 AMBERLY DR STE 195, TAMPA, FL 33647-1646
(813) 212-6517
Mailing address
15303 AMBERLY DR STE C, TAMPA, FL 33647-2308
(813) 212-6517
(813) 212-6518
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/22/2026
Last updated
06/23/2026
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