MEDICARE: DR. JANE TSUNG-WEN WONG FUTTERER 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	207R00000X	Internal Medicine Physician	MD.021509	LA

General Provider Information

NPI Number	:	1932893419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE TSUNG-WEN WONG FUTTERER MD

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	318-606-6737
Fax Number	:	833-749-0343

Provider Business Practice Location Address
First Line	:	2900 E TEXAS ST STE 100
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-3275
Country	:	US
Telephone Number	:	504-977-2712
Fax Number	:

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

Provider Enumeration Date	:	06/07/2023
Last Update Date	:	03/23/2026

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