Healthcare Provider Details

I. General information

NPI: 1043262173
Provider Name (Legal Business Name): JOHN V TRAN DPM MPH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 10/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1462 OAKFIELD DR
BRANDON FL
33511-4853
US

IV. Provider business mailing address

1462 OAKFIELD DR
BRANDON FL
33511-4853
US

V. Phone/Fax

Practice location:
  • Phone: 813-685-6922
  • Fax: 813-685-8308
Mailing address:
  • Phone: 813-685-6922
  • Fax: 813-685-8308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO3132
License Number StateFL

VIII. Authorized Official

Name: DR. JOHN VAN TRAN
Title or Position: PHYSICIAN/PRESIDENT
Credential: D.P.M., M.P.H.
Phone: 813-685-6922