Individual
THU-CUC NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1425 MALABAR RD NE, PALM BAY, FL 32907-2506
(321) 434-8078
(321) 434-8075
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-8078
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME133686
FL
208M00000X
Hospitalist Physician
Primary
ME133686
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111444800
—
FL
01
—
N8699
FL HF MEDICARE
FL
Enumeration date
03/28/2015
Last updated
10/18/2023
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