Individual
JOHNNY THANH SON NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610
(352) 273-8610
Mailing address
PO BOX 100254, GAINESVILLE, FL 32610-0254
(352) 273-8610
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
BP1-0050304
TX
207L00000X
Anesthesiology Physician
Primary
OS15404
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042900
—
FL
Enumeration date
06/19/2014
Last updated
07/20/2018
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