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General NPI Number Information
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NPI Number | 1154204766
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Entity Type | Organization
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Legal Business Name | ISLAND BEHAVIORAL HEALTH PLLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 13290 ISLAND RD
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City | FORT MYERS
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State | FL
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Zip | 33905-1808
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Country | US
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Telephone | 708-439-2883
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Fax | 844-996-1368
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Provider Business Mailing Address
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Address Line | 13290 ISLAND RD
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City | FORT MYERS
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State | FL
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Zip | 33905-1808
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Country | US
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Telephone | 708-439-2883
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Fax | 844-996-1368
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIN WANG
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Credential | MD
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Telephone | 708-439-2883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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