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Individual

THAIDUC NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
595 N COURTENAY PKWY STE 101, MERRITT ISLAND, FL 32953-4852
(321) 784-8211
(321) 394-9425
Mailing address
595 N COURTENAY PKWY STE 101, MERRITT ISLAND, FL 32953-4852
(321) 784-8211
(321) 394-8425

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
34 008818
OH
207L00000X
Anesthesiology Physician
OS13604
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
34008818
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
OS13604
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2699003
OH
Enumeration date
10/04/2006
Last updated
08/15/2019
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