Healthcare Provider Details
I. General information
NPI: 1447211396
Provider Name (Legal Business Name): FRANK K WANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/30/2006
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3100 SW 62 AVE
MIAMI FL
33155
US
IV. Provider business mailing address
PO BOX 558750
MIAMI FL
33255-8750
US
V. Phone/Fax
- Phone: 305-663-8409
- Fax: 305-663-8573
- Phone: 305-663-8409
- Fax: 305-663-8573
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | ME63929 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | ME63929 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: