Individual
LONG TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
117 NW 11TH AVE, DANIA BEACH, FL 33004-2608
(757) 650-5406
Mailing address
117 NW 11TH AVE, DANIA BEACH, FL 33004-2608
(757) 650-5406
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9378097
FL
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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