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General NPI Number Information
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NPI Number | 1114320645
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Entity Type | Organization
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Legal Business Name | WOUND CLINICS OF AMERICA CORP.
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 4440 PGA BLVD SUITE 600
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-6539
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Country | US
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Telephone | 772-486-2538
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Fax | 561-249-3062
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Provider Business Mailing Address
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Address Line | 4440 PGA BLVD SUITE 600
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-6539
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Country | US
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Telephone | 772-486-2538
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Fax | 561-249-3062
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LOUIS A VIAMONTES
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Credential | MD
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Telephone | 772-486-2538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME44853
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License Number State | FL
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