Basic Information
| Provider Information | |||||||||
| NPI: | 1992032841 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOUND SOLUTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2326 S CONGRESS AVE | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334067617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614335577 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2326 S CONGRESS AVE | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334067617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614335577 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2009 | ||||||||
| LastUpdateDate: | 01/28/2010 | ||||||||
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| AuthorizedOfficialLastName: | CAMACHO | ||||||||
| AuthorizedOfficialFirstName: | JESSICA | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5614335577 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | Y | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.