MEDICARE: LINH B. NGUYEN, MD, 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	207Q00000X	Family Medicine Physician	ME 83186	FL

General Provider Information

NPI Number	:	1053356949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINH B. NGUYEN, MD, PA

Provider Business Mailing Address
First Line	:	5265 PARK BLVD
Second Line	:	SUITE 100
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3451
Country	:	US
Telephone Number	:	727-545-9590
Fax Number	:	727-548-8590

Provider Business Practice Location Address
First Line	:	5265 PARK BLVD
Second Line	:	SUITE 100
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3451
Country	:	US
Telephone Number	:	727-545-9590
Fax Number	:	727-548-8590

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LINH BAO NGUYEN
Credential	:	M.D.
Telephone Number	:	727-545-9590

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/22/2020

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