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General NPI Number Information
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NPI Number | 1518757178
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Entity Type | Organization
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Legal Business Name | SUNWAVE WOUNDCARE
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 2093 W ATLANTIC AVE APT 4514
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4789
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Country | US
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Telephone | 585-469-5549
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Fax |
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Provider Business Mailing Address
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Address Line | 2093 W ATLANTIC AVE APT 4514
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City | DELRAY BEACH
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State | FL
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Zip | 33445-4789
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Country | US
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Telephone | 585-469-5549
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | BRIAN GOLDMAN
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Credential |
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Telephone | 585-469-5549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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