Individual
MAI TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12196 COUNTY ROAD 512, FELLSMERE, FL 32948-5463
(772) 257-8224
(772) 257-6575
Mailing address
12196 COUNTY ROAD 512, FELLSMERE, FL 32948-5463
(772) 257-8224
(772) 257-6575
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME104544
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001430900
—
FL
Enumeration date
05/10/2007
Last updated
07/11/2012
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