Healthcare Provider Details

I. General information

NPI: 1275726416
Provider Name (Legal Business Name): THUY NGO D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH ST S
ST PETERSBURG FL
33701-4630
US

IV. Provider business mailing address

501 6TH ST S
ST PETERSBURG FL
33701-4630
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 727-898-7451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0102202035
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberOS20089
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: