Organization
DFAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONG TRAN (LPN)
(757) 650-5406
Entity
Organization
Contact information
Practice address
1201 NW 16TH ST, MIAMI, FL 33125-1624
(305) 575-7000
Mailing address
571 SW 176TH AVE, PEMBROKE PINES, FL 33029-4010
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
0002074774
VA
314000000X
Skilled Nursing Facility
Primary
PN5186921
FL
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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