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Individual

BRIGHT WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-1944
(407) 303-1746
Mailing address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 767-0433
(407) 767-0608

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
ME75989
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME75989
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
256610900
FL
01
300112441
RR MEDICARE
FL
01
46889
BCBS OF FLORIDA
FL
Enumeration date
07/08/2005
Last updated
01/07/2019
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