# FERNANDO WONG SAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1083438089
- **Gender:** Man
- **Credential:** MDOM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 4576 | FL | Yes |
| 225700000X | Massage Therapist | 106005 | FL | — |

## Other

- **Enumeration date:** 11/14/2024
- **Last updated:** 11/14/2024