Provider Demographics
NPI:1275594897
Name:TRAN, ANTHONY H (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:H
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:111 E HIBISCUS BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3102
Mailing Address - Country:US
Mailing Address - Phone:321-768-3655
Mailing Address - Fax:321-831-3024
Practice Address - Street 1:111 E HIBISCUS BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3102
Practice Address - Country:US
Practice Address - Phone:321-768-3655
Practice Address - Fax:321-831-3024
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME95316207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1215520OtherAETNA
FL275173900Medicaid
FL330658OtherWELLCARE
FLP99431220OtherRAILROAD MEDICARE
FL7624796OtherAETNA
FL41122OtherBLUE CROSS BLUE SHIELD
FL3395905001OtherCIGNA
FL3395905001OtherCIGNA
FLI59224Medicare UPIN