Individual
BILLY SANA KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 BRICE BLVD, BARTOW, FL 33830-6735
(863) 519-8233
(863) 519-8304
Mailing address
1290 GOLFVIEW AVE, 4TH FLOOR BILLING DEPARTMENT, BARTOW, FL 33830-6738
(863) 519-7900
(863) 519-7696
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME50150
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061584600
—
FL
Enumeration date
10/10/2005
Last updated
08/11/2010
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