Provider Demographics
NPI:1982916151
Name:WOUND SURGEONS LLC
Entity Type:Organization
Organization Name:WOUND SURGEONS LLC
Other - Org Name:WOUND CARE SPECIALISTS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-598-6045
Mailing Address - Street 1:76 BATTERSON PARK RD STE 106
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2571
Mailing Address - Country:US
Mailing Address - Phone:203-598-6045
Mailing Address - Fax:203-879-0834
Practice Address - Street 1:76 BATTERSON PARK RD STE 106
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2571
Practice Address - Country:US
Practice Address - Phone:203-598-6045
Practice Address - Fax:203-879-0834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-05
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty