Healthcare Provider Details

I. General information

NPI: 1730380478
Provider Name (Legal Business Name): MICHAEL NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PONCE DE LEON BLVD SUITE 103
CORAL GABLES FL
33134-4474
US

IV. Provider business mailing address

2020 PONCE DE LEON BLVD SUITE 103
CORAL GABLES FL
33134-4474
US

V. Phone/Fax

Practice location:
  • Phone: 786-618-5039
  • Fax: 305-397-2227
Mailing address:
  • Phone: 786-618-5039
  • Fax: 305-397-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME-116391
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN10915
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number245841
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: