Provider Demographics
NPI:1346736816
Name:QUOC DANG DO LLC
Entity Type:Organization
Organization Name:QUOC DANG DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUOC BAO
Authorized Official - Middle Name:NHU
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:786-832-4487
Mailing Address - Street 1:1521 ALTON RD STE 729
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3301
Mailing Address - Country:US
Mailing Address - Phone:786-209-3451
Mailing Address - Fax:786-431-2509
Practice Address - Street 1:3475 SHERIDAN ST STE 201
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3659
Practice Address - Country:US
Practice Address - Phone:786-209-3451
Practice Address - Fax:786-431-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-07
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14038208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS14038OtherMEDICAL LICENSE