KELLY MARIE WONG (NPI# 1174803605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174803605 |
| Entity Type | Individual |
| Full Name | KELLY MARIE WONG |
| Credential | NP |
| Practice Address |
861 Sw 78th Ave Ste 200b Plantation FL 33324-3273 |
| Practice Telephone | 8776935700 |
| Mailing Telephone | 8776935700 |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2012-11-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP4100 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992176259 | Kelly Wong | Pharmacist | 1120 S Nt Vernon Ave, Colton, CA 92324 | 2015-10-13 |
| 1699865741 | Kelly Kwok Wong | Specialist | 728 Pacific Ave # 703, San Francisco, CA 94133-4457 | 2006-10-12 |
| 1194377572 | Kelly Wong | Behavior Technician | 8795 Folsom Blvd Ste 103, Sacramento, CA 95826-3720 | 2019-07-15 |
| 1306347364 | Kelly Wong | Behavior Technician | 5820 Stoneridge Mall Rd Ste 205, Pleasanton, CA 94588-3347 | 2018-02-26 |
| 1376073593 | Kelly Wong | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2017-06-20 |
| 1205174505 | Kelly Lee Wong | Internal Medicine | 3300 Webster St, 1000, Oakland, CA 94609-3117 | 2013-01-21 |
| 1710157318 | Kelly Wong | Nurse Practitioner | 4201 Henry Ave, Philadelphia University, Student Health Center, Philadelphia, PA 19144-5409 | 2008-03-11 |
| 1215106448 | Kelly Tim Tim Wong | Family Medicine | 711 W College St Ste 208, Los Angeles, CA 90012-1093 | 2008-02-21 |
| 1932289824 | Kelly Kristin Wong | Family Medicine | 250 E Yale Loop, Ste 204, Irvine, CA 92604-4697 | 2006-10-16 |
| Street Address |
861 SW 78TH AVE STE 200B |
| City | PLANTATION |
| State | FL |
| Zip Code | 33324-3273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033246194 | Margaret J Miller | Physician Assistant | 861 Sw 78th Ave, Suite #100b, Plantation, FL 33324-3273 | 2007-02-27 |
| 1396977708 | Stephen Vincent Warden | Physician Assistant | 861 Sw 78th Ave, #200b, Plantation, FL 33324-3273 | 2009-08-18 |
| 1295988517 | Charles A. Furr IIi | Physician Assistant | 861 Sw 78th Ave, # 100b, Plantation, FL 33324-3273 | 2008-10-30 |
| 1093967382 | Spruce Pine Emergency Physicians Pllc | Emergency Medicine | 861 Sw 78th Ave, # 100-b, Plantation, FL 33324-3273 | 2008-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790395382 | Jose A Zarranz | Pharmacist | 9648 Nw 7th Circle, Apt 1914, Plantation, FL 33324 | 2020-08-07 |
| 1275142234 | Leann Dehoff, Phd, Lmhc, Inc. | Clinic/Center | 150 S Pine Island Road, Suite 300, Unit 94, Plantation, FL 33324 | 2020-07-27 |
| 1881232890 | Clara Mary Gonzalez Guevara | Nurse Practitioner | 01 S University Dr, Suite C136, Plantation, FL 33324 | 2019-12-20 |
| 1568009231 | Beena K Bijoy | Nurse Practitioner | 10305 Nw 6th Street, Plantation, FL 33324 | 2019-12-02 |
| 1629636030 | Carey Brown | Behavior Technician | 3 S Pine Island Rd, Apt 215, Ft. Lauderdale, FL 33324 | 2019-05-31 |
| 1578076410 | Eden Avni | Physician Assistant | 950 S Pine Island Rd Ste A-180, Plantation, FL 33324 | 2017-11-14 |
| 1528597952 | Loretta Epsen | Counselor | 851 Nw 85th Terr #1906, Plantation, FL 33324 | 2017-06-08 |
| 1497289409 | Leann Gale Dehoff | Counselor | 150 South Pine Island Road, Suite 300, Unit 94, Plantation, FL 33324 | 2017-04-17 |
| 1851842918 | Maria Clara Rodriguez Andrade | Technician, Other | 2440 Sw 105 Terrace, Davie, FL 33324 | 2016-10-24 |
| 1447703947 | Herltg-debbie M Louis | Nurse Practitioner | 800 S University Dr, C-136, Plantation, FL 33324 | 2016-08-01 |
| Find all providers in zip 33324 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619582681 | Magalie Marie Chery | Nurse Practitioner | 1408 Nw 81st Ter, Plantation, FL 33322-4667 | 2020-09-15 |
| 1679182943 | Sophia Nadine Landell | Nurse Practitioner | 4580 Nw 6th Ct, Plantation, FL 33317-2150 | 2020-07-23 |
| 1518581529 | Jon Leigh Storey | Nurse Practitioner | 880 N Fig Tree Ln, Plantation, FL 33317-1348 | 2020-06-04 |
| 1568009231 | Beena K Bijoy | Nurse Practitioner | 10305 Nw 6th Street, Plantation, FL 33324 | 2019-12-02 |
| 1588206551 | Heather Anne Ruppel | Nurse Practitioner | 7535 Nw 2nd Ct, Plantation, FL 33317-2273 | 2019-10-11 |
| 1700443587 | Geanina Cabales Domingo | Nurse Practitioner | 9830 Nw 2nd Ct, Plantation, FL 33324-7088 | 2019-05-28 |
| 1467016550 | Stephanie Fajardo | Nurse Practitioner | 140 Sw 84th Ave Ste B, Plantation, FL 33324-2736 | 2019-04-24 |
| 1003479528 | Juliette Drexler | Nurse Practitioner | 700 Sw 78th Ave Apt 416, Plantation, FL 33324-3372 | 2019-04-19 |
| 1043775166 | Danielle Amanda Steele | Nurse Practitioner | 281 Nw 49th Ave, Plantation, FL 33317-2050 | 2019-02-02 |
| 1326502261 | Natalie Nadia Lachman | Nurse Practitioner | 1300 Sw 66th Ter, Plantation, FL 33317-5130 | 2019-01-24 |
| Find all providers in PLANTATION | ||||
| City | PLANTATION |
| Zip Code | 33324 |
Please comment or provide details below to improve the information on KELLY MARIE WONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.