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NPI Code Detail

MEDICARE: HEALING WOUNDS, HAPPIER HEARTS, LLC

MEDICARE: HEALING WOUNDS, HAPPIER HEARTS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2500XMedical Specialty Clinic/Center
2363LG0600XGerontology Nurse Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11316427313OTHERFLNPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114492394
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALING WOUNDS, HAPPIER HEARTS, LLC
Provider Business Mailing Address
First Line : 8852 SW 25TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33165-2019
Country : US
Telephone Number : 786-897-1748
Fax Number : 786-524-3165
Provider Business Practice Location Address
First Line : 8852 SW 25TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33165-2019
Country : US
Telephone Number : 786-897-1748
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. JOSUE ALBERTO MORAN
Credential : DNP, APRN, AGPCNP-BC
Telephone Number : 786-897-1748
Provider Enumeration Date : 10/03/2018
Last Update Date : 02/21/2023

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