MEDICARE: DR. ANDREW VINH TRAN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	8502	SC
2	225100000X	Physical Therapist	PT016327	OH
3	225100000X	Physical Therapist	PT34732	FL

General Provider Information

NPI Number	:	1225562754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW VINH TRAN DPT

Provider Business Mailing Address
First Line	:	1649 TAMIAMI TRL
Second Line	:	STE 1
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-1019
Country	:	US
Telephone Number	:	630-296-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2828 S MCCALL RD STE 25
Second Line	:
City	:	ENGLEWOOD
State	:	FL
Zip	:	34224-9517
Country	:	US
Telephone Number	:	941-474-2700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2017
Last Update Date	:	12/14/2021

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