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NPI Code Detail

MEDICARE: TRI COUNTY WOUND CARE LLC

MEDICARE: TRI COUNTY WOUND CARE 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
1103K00000XBehavior Analyst
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1538900709
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI COUNTY WOUND CARE LLC
Provider Business Mailing Address
First Line : 2628 FOREST HILL BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-5931
Country : US
Telephone Number : 786-351-4493
Fax Number :
Provider Business Practice Location Address
First Line : 2628 FOREST HILL BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-5931
Country : US
Telephone Number : 786-351-4493
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CARLOS REYES CHOUZA
Credential :
Telephone Number : 786-351-4493
Provider Enumeration Date : 06/03/2024
Last Update Date : 06/05/2024

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Directions to “TRI COUNTY WOUND CARE LLC ” Practice Location

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