Provider Demographics
NPI:1902326234
Name:WONG, WILSON CHIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILSON
Middle Name:CHIN
Last Name:WONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8288 BERMUDA SOUND WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1726
Mailing Address - Country:US
Mailing Address - Phone:561-523-3689
Mailing Address - Fax:
Practice Address - Street 1:8288 BERMUDA SOUND WAY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-1726
Practice Address - Country:US
Practice Address - Phone:561-523-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist