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General NPI Number Information
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NPI Number | 1073990578
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Entity Type | Organization
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Legal Business Name | WOUND CARE NATIONAL INC
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 14833 SW 173RD TER
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City | MIAMI
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State | FL
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Zip | 33187-6701
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Country | US
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Telephone | 305-389-0212
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Fax | 305-328-9659
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Provider Business Mailing Address
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Address Line | 14833 SW 173RD TER
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City | MIAMI
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State | FL
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Zip | 33187-6701
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Country | US
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Telephone | 305-389-0212
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Fax | 305-328-9659
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MONICA R MULET-HAM
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Credential | ARNP
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Telephone | 305-244-0423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9252211
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ARNP9252211
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License Number State | FL
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