Provider Demographics
NPI:1326688011
Name:NGUYEN, PAUL TUAN (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10280 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5561
Mailing Address - Country:US
Mailing Address - Phone:407-288-6478
Mailing Address - Fax:
Practice Address - Street 1:800 WESTWOOD SQ STE D
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8849
Practice Address - Country:US
Practice Address - Phone:407-790-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17594224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant