=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538669627
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RATCHADAKON TRAN APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2018
-----------------------------------------------------
Last Update Date | 11/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3379 W WOOLBRIGHT RD
-----------------------------------------------------
City | BOYNTON BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33436-7245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-448-7998
-----------------------------------------------------
Fax | 888-392-8649
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4654 E STATE ROAD 64 STE 267
-----------------------------------------------------
City | BRADENTON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34208-9029
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-448-7998
-----------------------------------------------------
Fax | 888-392-8649
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN9413084
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F02180533
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN9413084
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------