Provider Demographics
NPI:1376186411
Name:DINH, BAO QUOC (ASCP(MLS))
Entity Type:Individual
Prefix:
First Name:BAO
Middle Name:QUOC
Last Name:DINH
Suffix:
Gender:M
Credentials:ASCP(MLS)
Other - Prefix:
Other - First Name:BAO
Other - Middle Name:QUOC
Other - Last Name:DINH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4442 NW 36TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-5419
Mailing Address - Country:US
Mailing Address - Phone:352-328-7104
Mailing Address - Fax:
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:352-376-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246QM0706X
FL270230246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist