| Woundcare Specialists Of South Florida Inc | |
|
739 E 10th St Hialeah FL 33010-3635 | |
| (305) 363-4598 | |
| (305) 704-7012 |
| Full Name | Woundcare Specialists Of South Florida Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 739 E 10th St, Hialeah, Florida |
| Authorized Official Name and Position | Ernesto Leonel Diaz (OWNER) |
| Authorized Official Contact | 7863519892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woundcare Specialists Of South Florida Inc 739 E 10th St Hialeah FL 33010-3635 Ph: (305) 363-4598 | Woundcare Specialists Of South Florida Inc 739 E 10th St Hialeah FL 33010-3635 Ph: (305) 363-4598 |
| NPI Number | 1912735572 |
|---|---|
| Provider Enumeration Date | 07/24/2024 |
| Last Update Date | 08/07/2024 |
| Medicare PECOS PAC ID | 0345772158 |
|---|---|
| Medicare Enrollment ID | O20241017004417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912735572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ernesto Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477854198 PECOS PAC ID: 1254674591 Enrollment ID: I20190530000194 |
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