Provider Demographics
NPI:1942657572
Name:DIABETES AND WOUND CARE NETWORK INC
Entity Type:Organization
Organization Name:DIABETES AND WOUND CARE NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:
Authorized Official - Last Name:CAZAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-455-4284
Mailing Address - Street 1:777 E 25TH ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3825
Mailing Address - Country:US
Mailing Address - Phone:305-455-4284
Mailing Address - Fax:305-455-4285
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:SUITE 306
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-455-4284
Practice Address - Fax:305-455-4285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95970207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty