MEDICARE: ANNDY NGUYEN PA-C

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	363A00000X	Physician Assistant	PA9119185	FL

General Provider Information

NPI Number	:	1396571832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNDY NGUYEN PA-C

Provider Business Mailing Address
First Line	:	2590 HEALING WAY STE 220
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-5496
Country	:	US
Telephone Number	:	866-337-4251
Fax Number	:

Provider Business Practice Location Address
First Line	:	2590 HEALING WAY STE 220
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-5496
Country	:	US
Telephone Number	:	866-337-4251
Fax Number	:	847-381-8999

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

Provider Enumeration Date	:	09/11/2024
Last Update Date	:	04/03/2025

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Directions to “ ANNDY NGUYEN PA-C” Practice Location

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