Healthcare Provider Details

I. General information

NPI: 1598159758
Provider Name (Legal Business Name): WOUND CARE SPECIALIST WEST COAST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 SW 8TH ST STE 108
MIAMI FL
33144-4100
US

IV. Provider business mailing address

8300 SW 8TH ST STE 108
MIAMI FL
33144-4100
US

V. Phone/Fax

Practice location:
  • Phone: 786-482-5019
  • Fax: 786-482-5493
Mailing address:
  • Phone: 786-482-5019
  • Fax: 786-482-5493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE L MARRERO PADRINO
Title or Position: PRESIDENT
Credential:
Phone: 786-368-7918