Provider Demographics
NPI:1073990578
Name:WOUND CARE NATIONAL INC
Entity Type:Organization
Organization Name:WOUND CARE NATIONAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MULET-HAM
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:305-244-0423
Mailing Address - Street 1:14833 SW 173RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-6701
Mailing Address - Country:US
Mailing Address - Phone:305-389-0212
Mailing Address - Fax:305-328-9659
Practice Address - Street 1:14833 SW 173RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-6701
Practice Address - Country:US
Practice Address - Phone:305-389-0212
Practice Address - Fax:305-328-9659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9252211261QM2500X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty