MEDICARE: MICHELLE TRAN LY MD

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	ME158209	FL
2	208M00000X	Hospitalist Physician	ME158209	FL
3	208M00000X	Hospitalist Physician	2026-01639	NC

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	:	1710568449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE TRAN LY MD

Provider Business Mailing Address
First Line	:	2338 IMMOKALEE RD STE 186
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-1445
Country	:	US
Telephone Number	:	239-624-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2338 IMMOKALEE RD STE 186
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-1445
Country	:	US
Telephone Number	:	239-624-5000
Fax Number	:

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

Provider Enumeration Date	:	04/15/2021
Last Update Date	:	04/16/2026

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Directions to “ MICHELLE TRAN LY MD” Practice Location

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