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General NPI Number Information
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NPI Number | 1750564886
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Entity Type | Organization
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Legal Business Name | HIEU TRAC NGUYEN MD PA
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 499 N SR 434 SUITE 1011
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2142
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Country | US
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Telephone | 407-788-8118
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Fax | 407-788-8488
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Provider Business Mailing Address
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Address Line | 499 N SR 434 SUITE 1011
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2142
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Country | US
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Telephone | 407-788-8118
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Fax | 407-788-8488
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HIEU TRAC NGUYEN
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Credential | M.D.
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Telephone | 407-788-8118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME44030
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License Number State | FL
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