Healthcare Provider Details

I. General information

NPI: 1962999490
Provider Name (Legal Business Name): VINCENT WU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7271 SPRING HILL DR
SPRING HILL FL
34606-5066
US

IV. Provider business mailing address

5400 PINEHURST DR
SPRING HILL FL
34606-3833
US

V. Phone/Fax

Practice location:
  • Phone: 352-691-5040
  • Fax: 352-691-5042
Mailing address:
  • Phone: 352-277-5305
  • Fax: 352-616-0926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS17558
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: