Healthcare Provider Details

I. General information

NPI: 1881640050
Provider Name (Legal Business Name): JOHN QUAN VINH DAO D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 NORTH LAKE DESTINY DR
ORLANDO FL
32751-4844
US

IV. Provider business mailing address

3643 CARUSO PLACE
OVIEDO FL
32765
US

V. Phone/Fax

Practice location:
  • Phone: 407-200-2273
  • Fax: 407-381-4380
Mailing address:
  • Phone: 407-381-4810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS 9307
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: