# INTEGRATED WOUND CARE FLORIDA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699356964
- **Authorized official:** DR. DIANE LUSAS MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (732) 451-4318

## Contact information

- **Practice address:** 700 S 29TH ST, FORT PIERCE, FL 34947-3626
- **Practice address phone:** (732) 451-4318
- **Mailing address:** 492C CEDAR LN STE 514, TEANECK, NJ 07666-1713
- **Mailing address phone:** (732) 451-4318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2021
- **Last updated:** 04/19/2021