=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932257441
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TUONG QUY CHE M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 10/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 810 E COLONIAL DR
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32803-4606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-228-2126
-----------------------------------------------------
Fax | 407-228-2273
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3362 LUKAS CV
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32820-1416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-804-5505
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | ME99592
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------