Healthcare Provider Details

I. General information

NPI: 1164306627
Provider Name (Legal Business Name): TRINH LUONG RN, CEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 PANAMA CITY BEACH PKWY
PANAMA CITY BEACH FL
32407-2448
US

IV. Provider business mailing address

3426 ORLANDO RD
PANAMA CITY FL
32405-6943
US

V. Phone/Fax

Practice location:
  • Phone: 850-319-5978
  • Fax:
Mailing address:
  • Phone: 850-319-5978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number9375542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: