Organization
SOUTHEAST WOUNDCARE EXPERTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM DAVID LUCKY SR. M.D. (OWNER)
(305) 238-3990
Entity
Organization
Contact information
Practice address
13520 SW 152ND ST, NUMBER 771834, MIAMI, FL 33177-0101
(305) 238-3990
(305) 254-6331
Mailing address
13520 SW 152ND ST, NUMBER 771834, MIAMI, FL 33177-0194
(305) 238-3990
(305) 254-6331
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME29049
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038136500
—
FL
Enumeration date
11/11/2014
Last updated
03/23/2016
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