MEDICARE: WOUNDWORX CARE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1083564686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUNDWORX CARE CORP

Provider Business Mailing Address
First Line	:	URB LEVITOWN JR5 7MA SECCION
Second Line	:	C/ LIZZIE GRAHAM
City	:	TOA BAJA
State	:	PR
Zip	:	00949
Country	:	US
Telephone Number	:	787-444-1721
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB LEVITOWN JR5 7MA SECCION
Second Line	:	C/ LIZZIE GRAHAM
City	:	TOA BAJA
State	:	PR
Zip	:	00949
Country	:	US
Telephone Number	:	787-444-1721
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAYMOND D GERENA
Credential	:	ETC
Telephone Number	:	787-444-1721

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	06/04/2026

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