MEDICARE: WOUND CLINICS OF AMERICA 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	208600000X	Surgery Physician	ME44853	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114320645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND CLINICS OF AMERICA CORP.

Provider Business Mailing Address
First Line	:	4440 PGA BLVD
Second Line	:	SUITE 600
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6539
Country	:	US
Telephone Number	:	772-486-2538
Fax Number	:	561-249-3062

Provider Business Practice Location Address
First Line	:	4440 PGA BLVD
Second Line	:	SUITE 600
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6539
Country	:	US
Telephone Number	:	772-486-2538
Fax Number	:	561-249-3062

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LOUIS A VIAMONTES
Credential	:	MD
Telephone Number	:	772-486-2538

Provider Enumeration Date	:	09/29/2014
Last Update Date	:	05/27/2016

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Directions to “WOUND CLINICS OF AMERICA CORP. ” Practice Location

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