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Contact Information

CQC WOUND CLINIC PLLC
4101 NW 3RD CT STE 15
PLANTATION, FL33317-2830
 Phone: 786-207-4788
 Fax: 954-568-8630
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Wound Care

163WW0000X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CQC WOUND CLINIC PLLC · (Female)

NPI # 1114803996
Status Active
Credentials
Entity Individual
Enumeration date 08/15/2025
Last updated 02/24/2026 - About 3 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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