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General NPI Number Information
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NPI Number | 1801332424
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Entity Type | Individual
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Provider Name | PHUNG DUC NGUYEN M.D
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Gender | Male
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Dates
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Enumeration Date | 01/07/2017
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Last Update Date | 01/07/2017
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Provider Practice Location Address
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Address Line | 19225 US HIGHWAY 27
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City | CLERMONT
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State | FL
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Zip | 34715-9025
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Country | US
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Telephone | 352-989-9301
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Fax |
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Provider Business Mailing Address
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Address Line | 13151 MORO CT
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5016
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Country | US
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Telephone | 407-347-8003
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Fax | 407-347-8003
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME56547
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License Number State | FL
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