Provider Demographics
NPI:1093725772
Name:DAO, UYEN K (DPM)
Entity Type:Individual
Prefix:DR
First Name:UYEN
Middle Name:K
Last Name:DAO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17820 SE 109TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8968
Mailing Address - Country:US
Mailing Address - Phone:352-347-3338
Mailing Address - Fax:
Practice Address - Street 1:17820 SE 109TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8968
Practice Address - Country:US
Practice Address - Phone:352-347-3338
Practice Address - Fax:352-347-3389
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2852213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340262200Medicaid
FL340262200Medicaid
FL65679ZMedicare PIN
FL480032863Medicare PIN