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NPI Code Detail

MEDICARE: DR. JOYCE WONG MD

MEDICARE: DR. JOYCE WONG MD
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
1207R00000XInternal Medicine PhysicianME82752FL

General Provider Information

NPI Number : 1417925629
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOYCE WONG MD
Provider Business Mailing Address
First Line : 836 PRUDENTIAL DR STE 1400
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 836 PRUDENTIAL DR STE 1400
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8340
Country : US
Telephone Number : 904-396-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 09/09/2010

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Directions to “ DR. JOYCE WONG MD” Practice Location

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