Provider Demographics
NPI:1518757178
Name:SUNWAVE WOUNDCARE
Entity type:Organization
Organization Name:SUNWAVE WOUNDCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-469-5549
Mailing Address - Street 1:2093 W ATLANTIC AVE APT 4514
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4789
Mailing Address - Country:US
Mailing Address - Phone:585-469-5549
Mailing Address - Fax:
Practice Address - Street 1:2093 W ATLANTIC AVE APT 4514
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4789
Practice Address - Country:US
Practice Address - Phone:585-469-5549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty