Healthcare Provider Details

I. General information

NPI: 1508688151
Provider Name (Legal Business Name): WOUND SOLUTIONS HS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 NW 87TH AVE STE 500
DORAL FL
33178-2433
US

IV. Provider business mailing address

3750 NW 87TH AVE STE 500
DORAL FL
33178-2433
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7484
  • Fax:
Mailing address:
  • Phone: 305-284-7484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSE PELAYO
Title or Position: CEO
Credential:
Phone: 305-284-7484