MEDICARE: DR NGO MEDICAL CLINIC PA

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730417981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR NGO MEDICAL CLINIC PA

Provider Business Mailing Address
First Line	:	PO BOX 1515
Second Line	:
City	:	WINDERMERE
State	:	FL
Zip	:	34786-1515
Country	:	US
Telephone Number	:	407-412-5936
Fax Number	:	407-601-0413

Provider Business Practice Location Address
First Line	:	5168 W COLONIAL DR
Second Line	:	SUITE 40
City	:	ORLANDO
State	:	FL
Zip	:	32808-7604
Country	:	US
Telephone Number	:	407-412-5936
Fax Number	:	407-601-0413

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HUNG Q NGO
Credential	:	MD
Telephone Number	:	407-412-5936

Provider Enumeration Date	:	11/30/2009
Last Update Date	:	05/03/2010

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Directions to “DR NGO MEDICAL CLINIC PA ” Practice Location

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