Provider Demographics
NPI:1568760957
Name:NGUYEN, NHAT NGUYEN THI (DO)
Entity Type:Individual
Prefix:
First Name:NHAT NGUYEN
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-4412
Mailing Address - Country:US
Mailing Address - Phone:727-821-8700
Mailing Address - Fax:727-821-8700
Practice Address - Street 1:1530 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4412
Practice Address - Country:US
Practice Address - Phone:727-821-8700
Practice Address - Fax:727-821-8700
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL OS11517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine