MEDICARE: PHU TRAN D.C.

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	171100000X	Acupuncturist
2	111N00000X	Chiropractor	CH10655	FL

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	:	1871844654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHU TRAN D.C.

Provider Business Mailing Address
First Line	:	9724 N ARMENIA AVE STE 400
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-7550
Country	:	US
Telephone Number	:	813-530-9300
Fax Number	:	813-933-0968

Provider Business Practice Location Address
First Line	:	9724 N ARMENIA AVE STE 400
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-7550
Country	:	US
Telephone Number	:	813-530-9300
Fax Number	:	813-933-0968

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

Provider Enumeration Date	:	09/20/2012
Last Update Date	:	04/19/2022

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