Organization
DEERFIELD BEACH MEDICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAM QUOC NGUYEN D.O. (PRESIDENT)
(954) 725-8808
Entity
Organization
Contact information
Practice address
5300 W. HILLSBORO BLVD., SUITE 216, COCONUT CREEK, FL 33073
(954) 725-8808
(954) 725-8818
Mailing address
5300 W. HILLSBORO BLVD., SUITE 216, COCONUT CREEK, FL 33073
(954) 725-8808
(954) 725-8818
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS0008287
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000107864
HUMANA PROVIDER NUMBER
—
01
—
145360
AETNA PRIVIDER NUMBER
—
05
—
264678100
—
FL
01
—
289806
AVMED PROVIDER NUMBER
—
01
—
43340
NEIGBORHOOD HEALTH PROVID
—
01
—
51382
BLUE CROSS BLE SHIELD PRO
FL
05
—
H78725
—
FL
01
—
P2789955
OXFORD HEALTH PLANS PROVI
—
Enumeration date
07/17/2007
Last updated
01/09/2009
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