Healthcare Provider Details

I. General information

NPI: 1518385798
Provider Name (Legal Business Name): ANTONY THANH NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1082 E BRANDON BLVD
BRANDON FL
33511-5509
US

IV. Provider business mailing address

1082 E BRANDON BLVD
BRANDON FL
33511-5509
US

V. Phone/Fax

Practice location:
  • Phone: 813-689-9900
  • Fax: 813-653-9696
Mailing address:
  • Phone: 813-689-9900
  • Fax: 813-653-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME131329
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME131329
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: