Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Khongruk Wongkittiroch, DO

Individual provider Dermatology Physician · NPI 1205003068

Khongruk Wongkittiroch, DO is a Micrographic Dermatologic Surgery (Mds) in Fort Lauderdale, Florida. Graduated from Midwestern University, Chicago College of Osteopathic Med in 2008, 18 years ago. Practices with South Florida Surgical Specialists LLC, a 92-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
18
Trained at
Midwestern University, Chicago College of Osteopathic Med
Licensed in
FL
In the registry since
2008
Specialties on file
6
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2838 E Oakland Park Blvd Ste 201
Fort Lauderdale, FL 33306-1814
Phone: (954) 564-0040
Fax: (954) 564-0048
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence OS11792 (FL)
Clinical & Laboratory Dermatological Immunology Physician Taxonomy 207NI0002X · Licence OS11792 (FL)
Dermatopathology Physician Taxonomy 207ND0900X · Licence OS11792 (FL)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence OS11792 (FL)
Pediatric Dermatology Physician Taxonomy 207NP0225X · Licence OS11792 (FL)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence OS11792 (FL)

Record details

NPI number1205003068
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 12, 2008
Last updated in NPPESDecember 18, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Also practisesDERMATOLOGY
Medical schoolMIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduated 2008 (18 years in practice)
Group practice South Florida Surgical Specialists Llc — 92 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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