Provider Demographics
NPI:1912735572
Name:WOUNDCARE SPECIALISTS OF SOUTH FLORIDA INC
Entity type:Organization
Organization Name:WOUNDCARE SPECIALISTS OF SOUTH FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:LEONEL
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:305-363-4598
Mailing Address - Street 1:739 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3635
Mailing Address - Country:US
Mailing Address - Phone:305-363-4598
Mailing Address - Fax:305-704-7012
Practice Address - Street 1:16340 NW 59TH AVE STE 33014200
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-5601
Practice Address - Country:US
Practice Address - Phone:305-363-4598
Practice Address - Fax:305-704-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty