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General NPI Number Information
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NPI Number | 1740902220
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Entity Type | Organization
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Legal Business Name | WOUND CARE SOLUTIONS OF NWFL PLLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 126 S SHORE DR UNIT 10
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-5830
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Country | US
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Telephone | 850-541-3908
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Fax | 833-228-6377
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Provider Business Mailing Address
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Address Line | 126 S SHORE DR UNIT 10
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-5830
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Country | US
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Telephone | 850-541-3908
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Fax | 833-228-6377
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Authorized Official
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Title or Position | OWNER
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Name | MIRANDA BUSHNELL
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Credential |
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Telephone | 850-541-3908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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