Provider Demographics
NPI:1578214474
Name:QUYNH TRAM NHU NGUYEN P.A
Entity Type:Organization
Organization Name:QUYNH TRAM NHU NGUYEN P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:QUYNH TRAM
Authorized Official - Middle Name:NHU
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:469-274-0323
Mailing Address - Street 1:4050 ISLAND LAKES DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-5603
Mailing Address - Country:US
Mailing Address - Phone:469-274-0323
Mailing Address - Fax:
Practice Address - Street 1:4050 ISLAND LAKES DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-5603
Practice Address - Country:US
Practice Address - Phone:469-274-0323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty