Healthcare Provider Details

I. General information

NPI: 1891953485
Provider Name (Legal Business Name): TOM A HONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 CLEVELAND AVE
FORT MYERS FL
33901-4900
US

IV. Provider business mailing address

2531 CLEVELAND AVE STE 1
FORT MYERS FL
33901-4900
US

V. Phone/Fax

Practice location:
  • Phone: 239-334-7000
  • Fax: 239-334-7070
Mailing address:
  • Phone: 239-334-7000
  • Fax: 239-334-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME150312
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: