Provider Demographics
NPI:1598159758
Name:WOUND CARE SPECIALISTS WEST COAST.INC
Entity Type:Organization
Organization Name:WOUND CARE SPECIALISTS WEST COAST.INC
Other - Org Name:DADE HEALTHCARE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARRERO PADRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-368-7918
Mailing Address - Street 1:8300 SW 8TH ST STE 108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4100
Mailing Address - Country:US
Mailing Address - Phone:786-482-5019
Mailing Address - Fax:786-482-5493
Practice Address - Street 1:8300 SW 8TH ST STE 108
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4100
Practice Address - Country:US
Practice Address - Phone:786-482-5019
Practice Address - Fax:786-482-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN