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FANTASTIC WOUND CARE INC NPI 1457830804


NPI Information

NPI: 1457830804
Provider Name: FANTASTIC WOUND CARE INC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 10D2182859

Address:
2580 METROCENTRE BLVD STE 6
WEST PALM BEACH, FL
ZIP 33407
Phone: (561) 602-9988
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FANTASTIC WOUND CARE INC is a clinic center in West Palm Beach, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). FANTASTIC WOUND CARE INC NPI is 1457830804. The provider is registered as an organization entity type.

The provider's business location address is:

2580 METROCENTRE BLVD STE 6
WEST PALM BEACH, FL
ZIP 33407-100
Phone: (561) 602-9988

The provider's authorized official is Olayemi Osiyemi .
The authorized official title is President/part Owner and has the following contact phone number (561) 725-4100.

The CLIA number assigned to this NPI record is 10D2182859 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/7/2018 and was last updated on 7/29/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterFLORIDAYes
2261QI0500XClinic/CenterInfusion TherapyFLORIDANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.