Dr Wong, Med-Ped, P.a.
NPI #1205867975 in St Petersburg, Florida
Provider Information
- NPI Number
- 1205867975
- Entity Type
- Organization
- Organization Name
- Dr Wong, Med-Ped, P.a.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jul 5, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 461 7TH AVE S
- Address 2
- DR WONG, MED-PED, P.A.
- City
- St Petersburg
- State
- Florida
- ZIP Code
- 33701-4818
- Phone
- (727) 823-1111
Authorized Official
- Name
- DR. DANITA ROBERTA WONGCHANTARA, M.D.
- Title
- OWNER/PRESIDENT
- Phone
- (727) 823-1111
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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