Individual
BAO TRUNG TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 WATERMAN WAY, TAVARES, FL 32778-5266
(352) 253-3333
Mailing address
851 TRAFALGAR CT STE 200E, MAITLAND, FL 32751-7420
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11032617
FL
Other
Enumeration date
06/27/2023
Last updated
05/06/2024
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