Individual
JONATHAN C FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1540 S TAMIAMI TRL, SUITE 303, SARASOTA, FL 34239-2930
(941) 917-8791
(941) 917-8793
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME80268
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258797100
—
FL
01
—
49996
BCBS FL
FL
01
—
49996A
BCBSFL HMO
FL
01
—
49996B
BCBSFL HMO
FL
Enumeration date
06/28/2006
Last updated
03/01/2016
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