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General NPI Number Information
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NPI Number | 1194879460
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Entity Type | Individual
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Provider Name | THOMAS NGUYEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 05/24/2012
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Provider Practice Location Address
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Address Line | 2309 W WOOLBRIGHT RD SUITE 2
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6366
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Country | US
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Telephone | 561-634-7262
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Fax | 561-634-7265
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Provider Business Mailing Address
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Address Line | 2309 W WOOLBRIGHT RD SUITE 2
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6366
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Country | US
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Telephone | 561-634-7262
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Fax | 561-634-7265
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME105343
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME105343
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License Number State | FL
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