MEDICARE: NANCY NGUYEN O.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	152W00000X	Optometrist	OPC4736	FL

General Provider Information

NPI Number	:	1871842476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY NGUYEN O.D.

Provider Business Mailing Address
First Line	:	3375 PAISLEY CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-1944
Country	:	US
Telephone Number	:	407-437-0197
Fax Number	:

Provider Business Practice Location Address
First Line	:	706 W SR 436
Second Line	:	SUITE 1001
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-3048
Country	:	US
Telephone Number	:	407-865-7700
Fax Number	:

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

Provider Enumeration Date	:	08/29/2012
Last Update Date	:	08/29/2012

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