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General NPI Number Information
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NPI Number | 1497042774
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Entity Type | Individual
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Provider Name | CALREN S WANG PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 14155 TOWN LOOP BLVD
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City | ORLANDO
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State | FL
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Zip | 32837-6185
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Country | US
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Telephone | 872-231-3162
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7410884
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City | CHICAGO
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State | IL
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Zip | 60674-0884
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Country | US
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Telephone | 702-899-0595
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Fax | 702-977-1496
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 4495
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 9113609
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License Number State | FL
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