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General NPI Number Information
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NPI Number | 1104053750
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Entity Type | Organization
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Legal Business Name | ROBERT NGUYEN DPM LLC
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 2699 STIRLING RD SUITE A301/302
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-6517
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Country | US
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Telephone | 954-278-3890
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Fax | 954-251-1470
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Provider Business Mailing Address
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Address Line | 10273 SW 24TH ST
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City | MIRAMAR
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State | FL
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Zip | 33025-6507
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Country | US
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Telephone | 954-278-3890
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Fax | 954-251-1470
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT NGUYEN
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Credential | DPM
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Telephone | 630-688-1240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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