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General NPI Number Information
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NPI Number | 1972890424
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Entity Type | Individual
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Provider Name | MICHAEL WONG M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 8900 N KENDALL DR
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 786-596-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 247 DRIGGS AVE APT 4D
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City | BROOKLYN
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State | NY
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Zip | 11222-5404
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Country | US
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Telephone | 310-562-0649
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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 | MT200435
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 283597
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | ME158538
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License Number State | FL
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