Organization
BREVARD WOUND CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL MATEOS-MORA MD (OWNER/OPERATOR)
(321) 254-1611
Entity
Organization
Contact information
Practice address
445 PINEDA CT, MELBOURNE, FL 32940-7555
(321) 254-1611
(321) 254-3166
Mailing address
445 PINEDA CT, MELBOURNE, FL 32940-7555
(321) 254-1611
(321) 254-3166
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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