Organization
SPACECOAST WOUND SPECIALIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNE ARRUDA-WENNBERG (OWNER)
(321) 720-3014
Entity
Organization
Contact information
Practice address
770 SCHUSTER RD SW, PALM BAY, FL 32908-1711
(321) 720-3014
Mailing address
770 SCHUSTER RD SW, PALM BAY, FL 32908-1711
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
09/05/2024
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