Provider Demographics
NPI:1619525797
Name:TRUONG, LAN ANH (DPT)
Entity Type:Individual
Prefix:DR
First Name:LAN ANH
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14422 SHORESIDE WAY
Mailing Address - Street 2:SUITE 110 PMB 169
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4510
Mailing Address - Country:US
Mailing Address - Phone:407-595-8962
Mailing Address - Fax:
Practice Address - Street 1:15632 SUNQUAT DR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5078
Practice Address - Country:US
Practice Address - Phone:407-595-8962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-31
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist