Healthcare Provider Details

I. General information

NPI: 1609797869
Provider Name (Legal Business Name): KAYDEN NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7234 SHADY GROVE LN
BOYNTON BEACH FL
33436-9406
US

IV. Provider business mailing address

7234 SHADY GROVE LN
BOYNTON BEACH FL
33436-9406
US

V. Phone/Fax

Practice location:
  • Phone: 561-306-3270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471N0900X
TaxonomyNuclear Medicine Technology Radiologic Technologist
License Number107654
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: