MEDICARE: PHILIP 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
1	208800000X	Urology Physician	215130	MA
2	208800000X	Urology Physician	ME132157	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932168267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP WONG MD

Provider Business Mailing Address
First Line	:	2160 COLONIAL BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1410
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	6376 PINE RIDGE RD UNIT 460
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3928
Country	:	US
Telephone Number	:	239-799-1100
Fax Number	:

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	07/22/2025

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Directions to “ PHILIP WONG MD” Practice Location

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