MEDICARE: MS. KAYLA WONG LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA52575	FL

General Provider Information

NPI Number	:	1023329422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAYLA WONG LMT

Provider Business Mailing Address
First Line	:	478 E ALTAMONTE DR # 108-308
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4628
Country	:	US
Telephone Number	:	850-225-5224
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 CAPE COD LN STE 9
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-2144
Country	:	US
Telephone Number	:	850-225-5224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	01/12/2020

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