MEDICARE: DAVID NGUYEN D O PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081H0002X	Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician	OS7942	FL

General Provider Information

NPI Number	:	1013126127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID NGUYEN D O PA

Provider Business Mailing Address
First Line	:	4640 PARK BLVD
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3529
Country	:	US
Telephone Number	:	727-532-9906
Fax Number	:	727-532-9769

Provider Business Practice Location Address
First Line	:	4640 PARK BLVD
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3529
Country	:	US
Telephone Number	:	727-532-9906
Fax Number	:	727-532-9769

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. DAVID THANH NGUYEN
Credential	:	D.O.
Telephone Number	:	727-532-9906

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	04/10/2008

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Directions to “DAVID NGUYEN D O PA ” Practice Location

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