Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | OS15310 | FL |
NPI | 1467834572 |
---|---|
Provider Name | Dr. Johnny Khoa Nguyen |
First Address | West Palm Beach, FL 33409-6501 |
Second Address | Fort Myers, FL 33908-7684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2015 |
Last Update Date | 01/11/2021 |