Healthcare Provider Details

I. General information

NPI: 1932174679
Provider Name (Legal Business Name): TUAN QUOC HOANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13695 US HIGHWAY 1
SEBASTIAN FL
32958-3230
US

IV. Provider business mailing address

13695 US HIGHWAY 1
SEBASTIAN FL
32958-3230
US

V. Phone/Fax

Practice location:
  • Phone: 716-603-8140
  • Fax:
Mailing address:
  • Phone: 716-603-8140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101228979
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME130253
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: