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General NPI Number Information
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NPI Number | 1275768335
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Entity Type | Organization
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Legal Business Name | WOUND CARE ON WHEELS LLC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 8833 PERIMETER PARK BLVD SUITE 501
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1109
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Country | US
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Telephone | 904-642-0877
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Fax |
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Provider Business Mailing Address
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Address Line | 8833 PERIMETER PARK BLVD SUITE 501
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1109
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Country | US
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Telephone | 904-642-0877
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DE ANNA M BELL
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Credential | ARNP
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Telephone | 904-382-4243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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