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General NPI Number Information
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NPI Number | 1700806312
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Entity Type | Organization
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Legal Business Name | TZEWAN WONG MD PA
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 10420 SW 77TH AVE 100
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City | PINECREST
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State | FL
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Zip | 33156-3771
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Country | US
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Telephone | 305-668-4484
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Fax | 305-668-4994
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Provider Business Mailing Address
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Address Line | 10420 SW 77TH AVE 100
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City | PINECREST
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State | FL
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Zip | 33156-3771
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Country | US
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Telephone | 305-668-4484
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Fax | 305-668-4994
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. TZEWAN WONG
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Credential | MD
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Telephone | 305-668-4484
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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 | ME0054738
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License Number State | FL
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