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NPI Code Detail

MEDICARE: DZUY LE MD LLC

MEDICARE: DZUY LE MD LLC
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
1208600000XSurgery PhysicianME79752FL

General Provider Information

NPI Number : 1851577415
Entity Type Code : Organization
Provider Name (Legal Business Name) : DZUY LE MD LLC
Provider Business Mailing Address
First Line : 150 N SYKES CREEK PKWY
Second Line : # 300
City : MERRITT ISLAND
State : FL
Zip : 32953-3488
Country : US
Telephone Number : 321-449-4168
Fax Number : 321-449-4164
Provider Business Practice Location Address
First Line : 211 CORAL SANDS DR
Second Line : SUITE B
City : ROCKLEDGE
State : FL
Zip : 32955-2749
Country : US
Telephone Number : 321-690-0709
Fax Number : 321-690-0976
Authorized Official
Title or Position : MSO CREDENTIALING COORDINATOR
Name : SANDI LAROCHE
Credential :
Telephone Number : 321-449-4168
Provider Enumeration Date : 01/14/2008
Last Update Date : 08/06/2010

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Directions to “DZUY LE MD LLC ” Practice Location

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