Individual
LAWRENCE WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12662 TELECOM DR, TEMPLE TERRACE, FL 33637-0935
(813) 910-8708
(855) 852-7153
Mailing address
12662 TELECOM DR, TEMPLE TERRACE, FL 33637-0935
(813) 910-8708
(855) 852-7153
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME99695
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280444100
—
FL
Enumeration date
06/18/2007
Last updated
04/25/2017
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