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NPI 1639755416

NPI 1639755416 : PHAT MINH TRAN MD : ORLANDO, FL

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General NPI Number Information
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    NPI Number           |    1639755416
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    Entity Type          |    Individual 
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    Provider Name        |    PHAT MINH TRAN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/22/2021
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    Last Update Date     |    06/13/2025
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Provider Practice Location Address
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    Address Line         |    9464 E COLONIAL DR 
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32817-4150
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    Country              |    US
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    Telephone            |    407-482-9788
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    Fax                  |    407-482-7998
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Provider Business Mailing Address
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    Address Line         |    9464 E COLONIAL DR 
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32817-4150
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    Country              |    US
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    Telephone            |    407-482-9788
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    Fax                  |    407-482-7998
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    MD.47964
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    License Number State |    AL
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    ME169976
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    License Number State |    FL
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