Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 15552 | SC |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME142633 | FL |
NPI | 1124097886 |
---|---|
Provider Name | Tuan Nmn Nguyenduy |
First Address | Sanford, FL 32771-1018 |
Second Address | Sanford, FL 32771-1018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 28/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
195808 | MEDCOST (01) | SC |
4242025 | AETNA (01) | SC |
890586X | (05) | NC |
B744975019 | MEDICARE PIN (01) | SC |
TL5083 | (05) | SC |