MEDICARE: DR. NICHOLAS Q. TRINH M.D.

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 87310	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245349364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS Q. TRINH M.D.

Provider Business Mailing Address
First Line	:	3291 AMACA CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-7142
Country	:	US
Telephone Number	:	386-774-0491
Fax Number	:

Provider Business Practice Location Address
First Line	:	2669 ENTERPRISE RD
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8217
Country	:	US
Telephone Number	:	386-774-0491
Fax Number	:	386-774-7854

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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