Healthcare Provider Details

I. General information

NPI: 1669452983
Provider Name (Legal Business Name): HOA N. NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4651 SHERIDAN ST STE 470
HOLLYWOOD FL
33021-3437
US

IV. Provider business mailing address

4651 SHERIDAN ST STE 470
HOLLYWOOD FL
33021-3437
US

V. Phone/Fax

Practice location:
  • Phone: 954-986-6667
  • Fax: 954-983-6665
Mailing address:
  • Phone: 954-986-6667
  • Fax: 954-983-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME50821
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME50821
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberME50821
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberME50821
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: