Healthcare Provider Details

I. General information

NPI: 1417053331
Provider Name (Legal Business Name): WONDER INTERNATIONAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 N UNIVERSITY DR STE 103
TAMARAC FL
33321-2102
US

IV. Provider business mailing address

2165 SW 130TH TER
MIRAMAR FL
33027-2660
US

V. Phone/Fax

Practice location:
  • Phone: 954-752-8888
  • Fax: 954-721-8843
Mailing address:
  • Phone: 954-752-8888
  • Fax: 954-441-8532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP595
License Number StateFL

VIII. Authorized Official

Name: DR. DI FU
Title or Position: PRESIDENT
Credential: A.P.
Phone: 954-752-8888