1649147091 NPI number — ADVANCED INFECTIOUS DISEASES &WOUND CARE SPECIALIST LLC

Table of content: (NPI 1649147091)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649147091 NPI number — ADVANCED INFECTIOUS DISEASES &WOUND CARE SPECIALIST LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED INFECTIOUS DISEASES &WOUND CARE SPECIALIST LLC
Provider Last Name:
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Provider Middle Name:
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Provider Gender Code:

Provider's Other Name Information

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NPI Number Information

NPI Number:
1649147091
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
581 AUTUMN ASH DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLERMONT
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34715-0009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
581 AUTUMN ASH DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLERMONT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34715-0009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-434-6418
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2025

Additional Information

Authorized Official

Authorized Official Last Name:
LALANE DEL CASTILLO
Authorized Official First Name:
NEGIA
Authorized Official Middle Name:
ELISA
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
917-434-6418

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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