Healthcare Provider Details

I. General information

NPI: 1184856155
Provider Name (Legal Business Name): MONICA TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PALENCIA VILLAGE DR STE 107
SAINT AUGUSTINE FL
32095-8553
US

IV. Provider business mailing address

PO BOX 100237
GAINESVILLE FL
32610-0237
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-3200
  • Fax:
Mailing address:
  • Phone: 352-392-4541
  • Fax: 352-294-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME124888
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: