MEDICARE: DR. ANTHONY F. AFONG M.D.

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	208VP0014X	Interventional Pain Medicine Physician	ME77049	FL
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	ME77049	FL
3	174400000X	Specialist	ME77049	FL
4	208100000X	Physical Medicine & Rehabilitation Physician	ME77049	FL

General Provider Information

NPI Number	:	1801864160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY F. AFONG M.D.

Provider Business Mailing Address
First Line	:	11350 MCCORMICK RD.
Second Line	:	EXECUTIVE PLAZA 1, SUITE 501
City	:	HUNT VALLEY
State	:	MD
Zip	:	21031
Country	:	US
Telephone Number	:	678-841-7135
Fax Number	:	678-841-7123

Provider Business Practice Location Address
First Line	:	150 SW CHAMBER COURT
Second Line	:	SUITE 105
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-3413
Country	:	US
Telephone Number	:	772-807-9000
Fax Number	:	772-807-9087

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	08/03/2023

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