Dr Wong, Med-Ped, P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME0076151 Issued in FL

Legal business name

DR WONG, MED-PED, P.A.

Practice address

461 7TH Ave S
Dr Wong, Med-Ped, P.a.
St Petersburg, FL 33701-4818

Phone

(727) 823-1111

Fax

(727) 823-4153

NPI assigned

Jul 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Danita Roberta Wongchantara, M.D.

Title

Owner/President

Phone

(727) 823-1111

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nathan Tang, MD

  • Allergy & Immunology Physician
  • St Petersburg, FL
  • NPI 1871504746
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205867975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 7TH AVE S",
            "address_2": "DR WONG, MED-PED, P.A.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014818",
            "telephone_number": "727-823-1111",
            "fax_number": "727-823-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 7TH AVE S",
            "address_2": "DR WONG, MED-PED, P.A.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014818",
            "telephone_number": "727-823-1111",
            "fax_number": "727-823-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR WONG, MED-PED, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WONGCHANTARA",
        "authorized_official_first_name": "DANITA",
        "authorized_official_middle_name": "ROBERTA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "727-823-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0076151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dr. Jeff Kopelman, DPM

• Primary Care Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.