Individual
SAN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
8380 RIVERWALK PARK BLVD STE 100, FORT MYERS, FL 33919-8758
(239) 343-9960
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3800
(232) 343-3993
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9232935
FL
364S00000X
Clinical Nurse Specialist
APRN9232935
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024233400
—
FL
Enumeration date
02/21/2018
Last updated
07/02/2024
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