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General NPI Number Information
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NPI Number | 1487842563
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Entity Type | Individual
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Provider Name | YU HO WONG M.D.,
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Gender | Male
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Dates
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Enumeration Date | 10/14/2007
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 731 N CLYDE MORRIS BLVD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1603
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Country | US
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Telephone | 386-257-1626
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Fax | 866-486-1253
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 200
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City | MIAMI
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State | FL
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Zip | 33126-3168
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Country | US
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Telephone | 305-500-2000
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0068825
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License Number State | FL
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