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General NPI Number Information
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NPI Number | 1659798122
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Entity Type | Individual
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Provider Name | MY TIEN THUY NGUYEN DO
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Gender | Female
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-3618
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Country | US
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Telephone | 352-265-5911
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-2052
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Fax | 239-343-5348
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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 | 76874
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | OS18292
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License Number State | FL
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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 | OS18292
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License Number State | FL
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