MEDICARE: WOUND HOUSE LLC

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	:	1245186501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND HOUSE LLC

Provider Business Mailing Address
First Line	:	1953 CALLE CACIQUE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1953 CALLE CACIQUE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1413
Country	:	US
Telephone Number	:	678-640-9664
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	SCOTT DAMRON
Credential	:
Telephone Number	:	678-640-9664

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “WOUND HOUSE LLC ” Practice Location

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