Provider Demographics
NPI:1801787023
Name:MOBILE ADVANTAGE WOUND CARE LLC
Entity type:Organization
Organization Name:MOBILE ADVANTAGE WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:BIBISH
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKENA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:713-941-0809
Mailing Address - Street 1:220 N KIRKMAN RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-1102
Mailing Address - Country:US
Mailing Address - Phone:713-941-0809
Mailing Address - Fax:
Practice Address - Street 1:220 N KIRKMAN RD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-1102
Practice Address - Country:US
Practice Address - Phone:713-941-0809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health