Provider Demographics
NPI:1437038767
Name:WONG, WILSON HAI DUNG (DPT)
Entity type:Individual
Prefix:DR
First Name:WILSON
Middle Name:HAI DUNG
Last Name:WONG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3487 NW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1103
Mailing Address - Country:US
Mailing Address - Phone:547-396-2339
Mailing Address - Fax:
Practice Address - Street 1:3487 NW 30TH ST
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33311-1103
Practice Address - Country:US
Practice Address - Phone:954-739-6233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT42764208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation