Provider Demographics
NPI:1942558416
Name:WONG, PAOLO YUK-CHI (DC)
Entity Type:Individual
Prefix:DR
First Name:PAOLO
Middle Name:YUK-CHI
Last Name:WONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11730 LAKE CLAIR CIR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8815
Mailing Address - Country:US
Mailing Address - Phone:352-404-6385
Mailing Address - Fax:
Practice Address - Street 1:1507 S HIAWASSEE RD
Practice Address - Street 2:STE 214
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5718
Practice Address - Country:US
Practice Address - Phone:352-404-6385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00703200111N00000X
FLCH 10600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor