Provider Demographics
NPI:1861053985
Name:WU, WEN Y (DO)
Entity type:Individual
Prefix:
First Name:WEN
Middle Name:Y
Last Name:WU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7224
Mailing Address - Country:US
Mailing Address - Phone:954-276-3000
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:6730 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-4838
Practice Address - Country:US
Practice Address - Phone:542-769-5552
Practice Address - Fax:954-985-1411
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2025-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS17818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL125173500Medicaid