Healthcare Provider Details

I. General information

NPI: 1992888515
Provider Name (Legal Business Name): DAVID BUI MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 N HAMPTON AVE
ORLANDO FL
32803-4234
US

IV. Provider business mailing address

700 N HAMPTON AVE
ORLANDO FL
32803-4234
US

V. Phone/Fax

Practice location:
  • Phone: 407-895-3407
  • Fax: 407-898-8000
Mailing address:
  • Phone: 407-895-3407
  • Fax: 407-898-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME 60771
License Number StateFL

VIII. Authorized Official

Name: DAVID QUANG BUI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 407-895-3407