Provider Demographics
NPI:1144873779
Name:WSN NURSING HOME SERVICES
Entity type:Organization
Organization Name:WSN NURSING HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NUTOVITS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-330-0111
Mailing Address - Street 1:PO BOX 6068
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33482-6068
Mailing Address - Country:US
Mailing Address - Phone:561-330-7635
Mailing Address - Fax:561-330-7635
Practice Address - Street 1:7900 VENTURE CENTER WAY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-7402
Practice Address - Country:US
Practice Address - Phone:561-330-0111
Practice Address - Fax:561-330-7635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty