MEDICARE: DR. LINDA MAC NGUYEN M.D.

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	207P00000X	Emergency Medicine Physician	ME112192	FL

General Provider Information

NPI Number	:	1326275405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA MAC NGUYEN M.D.

Provider Business Mailing Address
First Line	:	1400 VILLAGE SQUARE BLVD # 3-80260
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-1250
Country	:	US
Telephone Number	:	646-632-2456
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 NW 49TH ST STE 140
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3723
Country	:	US
Telephone Number	:	954-714-6300
Fax Number	:

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

Provider Enumeration Date	:	06/16/2009
Last Update Date	:	06/10/2021

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