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NPI Code Detail

MEDICARE: DR. THANH CONG VAN DPM

MEDICARE: DR. THANH CONG VAN DPM
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
1213E00000XPodiatristPO4368FL

Other Identifiers

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

General Provider Information

NPI Number : 1821618661
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THANH CONG VAN DPM
Provider Business Mailing Address
First Line : 2724 N HIAWASSEE RD STE 100
Second Line :
City : ORLANDO
State : FL
Zip : 32818-3003
Country : US
Telephone Number : 407-906-0082
Fax Number : 407-604-2606
Provider Business Practice Location Address
First Line : 2724 N HIAWASSEE RD STE 100
Second Line :
City : ORLANDO
State : FL
Zip : 32818-3003
Country : US
Telephone Number : 407-906-0082
Fax Number : 407-604-2606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2020
Last Update Date : 09/22/2023

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Directions to “ DR. THANH CONG VAN DPM” Practice Location

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