=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225992910
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WC REGION 6 LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2025
-----------------------------------------------------
Last Update Date | 12/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 433 PLAZA REAL STE 275
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33432-3999
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-676-3500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 433 PLAZA REAL STE 275
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33432-3999
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-676-3500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | PETER GILLOOLY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 512-676-3500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364SC2300X
-----------------------------------------------------
Taxonomy Name | Chronic Care Clinical Nurse Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------