Healthcare Provider Details

I. General information

NPI: 1508789264
Provider Name (Legal Business Name): PUERTO RICO WOUND CARE CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VILLA DE TORRIMAR 403 REINA ISABEL
GUAYNABO PR
00969-3207
US

IV. Provider business mailing address

VILLA DE TORRIMAR 403 REINA ISABEL
GUAYNABO PR
00969-3207
US

V. Phone/Fax

Practice location:
  • Phone: 787-502-0242
  • Fax:
Mailing address:
  • Phone: 787-502-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MIGUEL ANZALOTA
Title or Position: CEO
Credential: MD
Phone: 787-502-0242