Provider Demographics
NPI:1386669877
Name:VU, LANI PHUONG (MD)
Entity Type:Individual
Prefix:DR
First Name:LANI
Middle Name:PHUONG
Last Name:VU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PHUONG
Other - Middle Name:HOANG
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1333 3RD AVE S STE 301
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6499
Mailing Address - Country:US
Mailing Address - Phone:239-262-2020
Mailing Address - Fax:239-435-1084
Practice Address - Street 1:1333 3RD AVE S STE 301
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6499
Practice Address - Country:US
Practice Address - Phone:239-262-2020
Practice Address - Fax:239-435-1084
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4626207W00000X
FLME99048207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAF936ZOtherMEDICARE PTAN
P00446538OtherRAILROAD MEDICARE PTAN
06751OtherBLUE CROSS BLUE SHIELD