Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | ME131912 | FL |
NPI | 1043626963 |
---|---|
Provider Name | Vania Phuoc |
First Address | Tampa, FL 33612-9416 |
Second Address | Tampa, FL 33612-9416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2014 |
Last Update Date | 11/02/2020 |