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General NPI Number Information
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NPI Number | 1649378761
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Entity Type | Individual
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Provider Name | PHAN NGUYEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 1890 SW HEALTH PKWY STE 303
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City | NAPLES
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State | FL
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Zip | 34109-0473
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Country | US
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Telephone | 239-593-0990
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 81798
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City | CLEVELAND
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State | OH
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Zip | 44181-0798
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Country | US
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Telephone | 613-002-4105
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Fax |
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 5101013356
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | OS12836
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License Number State | FL
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