Provider Demographics
NPI:1942879945
Name:DEPENDABLE WOUND CARE SERVICES, LLC
Entity Type:Organization
Organization Name:DEPENDABLE WOUND CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:
Authorized Official - Last Name:GASCON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-804-6676
Mailing Address - Street 1:3595 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3595 W 20TH AVE STE 125
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4537
Practice Address - Country:US
Practice Address - Phone:305-804-6676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty