Healthcare Provider Details

I. General information

NPI: 1760184964
Provider Name (Legal Business Name): AVINA DUONG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 BRANDON MAIN ST STE A
BRANDON FL
33511-5018
US

IV. Provider business mailing address

38135 MARKET SQUARE DR
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 813-315-1530
  • Fax: 813-355-5909
Mailing address:
  • Phone: 813-315-1530
  • Fax: 813-355-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS23752
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: