Provider Demographics
NPI:1104620921
Name:LAM, ALEX NGHIA
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:NGHIA
Last Name:LAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NE 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-7041
Mailing Address - Country:US
Mailing Address - Phone:813-999-1516
Mailing Address - Fax:813-441-8519
Practice Address - Street 1:200 NE 25TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-7041
Practice Address - Country:US
Practice Address - Phone:813-999-1516
Practice Address - Fax:813-441-8519
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038621363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health