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Organization

DR WONG, MED-PED, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANITA ROBERTA WONGCHANTARA M.D. (OWNER/PRESIDENT)
(727) 823-1111
Entity
Organization

Contact information

Practice address
461 7TH AVE S, DR WONG, MED-PED, P.A., ST PETERSBURG, FL 33701-4818
(727) 823-1111
(727) 823-4153
Mailing address
461 7TH AVE S, DR WONG, MED-PED, P.A., ST PETERSBURG, FL 33701-4818
(727) 823-1111
(727) 823-4153

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME0076151
FL

Other

Enumeration date
07/05/2006
Last updated
08/22/2020
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