Individual
DR. JONG HO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H
Contact information
Practice address
2125 CRYSTAL GROVE DR, LAKELAND, FL 33801-6875
(863) 688-2334
Mailing address
9707 63RD RD APT 3L, REGO PARK, NY 11374-1610
(718) 278-5138
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
254362
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME119926
FL
Other
Enumeration date
06/16/2008
Last updated
06/17/2014
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