Healthcare Provider Details

I. General information

NPI: 1467424564
Provider Name (Legal Business Name): CHAU NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 CYPRESS PKWY STE 100
KISSIMMEE FL
34759-3315
US

IV. Provider business mailing address

339 CYPRESS PKWY STE 100
KISSIMMEE FL
34759-3315
US

V. Phone/Fax

Practice location:
  • Phone: 407-343-3333
  • Fax: 407-343-8888
Mailing address:
  • Phone: 407-343-3333
  • Fax: 407-343-8888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME65090
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: