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General NPI Number Information
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NPI Number | 1437038767
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Entity Type | Individual
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Provider Name | WILSON HAI DUNG WONG DPT
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Gender | Male
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 3487 NW 30TH ST
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33311-1103
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Country | US
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Telephone | 954-739-6233
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Fax |
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Provider Business Mailing Address
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Address Line | 3487 NW 30TH ST
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33311-1103
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Country | US
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Telephone | 547-396-2339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PT42764
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License Number State | FL
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