Individual
EMMA GONG PARENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8201 W BLVD, PLANTATION, FL 33324-3332
(954) 829-0639
Mailing address
8201 W BLVD, PLANTATION, FL 33324
(954) 829-0639
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2025
Last updated
04/03/2025
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