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General NPI Number Information
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NPI Number | 1922209675
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Entity Type | Individual
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Provider Name | QUANG THANH NGUYEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 3305 SW 34TH CIR SUITE 200
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City | OCALA
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State | FL
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Zip | 34474-6616
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Country | US
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Telephone | 352-401-7575
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Fax | 352-401-7577
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Provider Business Mailing Address
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Address Line | 4881 NW 8TH AVE SUITE
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City | GAINESVILLE
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State | FL
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Zip | 32605-4582
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Country | US
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Telephone | 352-373-6338
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Fax | 352-373-6144
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME109477
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME109477
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License Number State | FL
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