Provider Demographics
NPI:1508927567
Name:NGUYEN, YEN K (DC)
Entity Type:Individual
Prefix:DR
First Name:YEN
Middle Name:K
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 WEKIVA SPRINGS RD STE 117
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3614
Mailing Address - Country:US
Mailing Address - Phone:689-222-1612
Mailing Address - Fax:
Practice Address - Street 1:397 WEKIVA SPRINGS RD STE 117
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3614
Practice Address - Country:US
Practice Address - Phone:689-222-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8154111N00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001930000Medicaid