Healthcare Provider Details

I. General information

NPI: 1225992910
Provider Name (Legal Business Name): WC REGION 6 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 PLAZA REAL STE 275
BOCA RATON FL
33432-3999
US

IV. Provider business mailing address

433 PLAZA REAL STE 275
BOCA RATON FL
33432-3999
US

V. Phone/Fax

Practice location:
  • Phone: 512-676-3500
  • Fax:
Mailing address:
  • Phone: 512-676-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SC2300X
TaxonomyChronic Care Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: PETER GILLOOLY
Title or Position: DIRECTOR
Credential:
Phone: 512-676-3500