Provider Demographics
NPI:1659541662
Name:CAO, TRANG C
Entity Type:Individual
Prefix:
First Name:TRANG
Middle Name:C
Last Name:CAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MIRACLE STRIP PKWY SE UNIT B14
Mailing Address - Street 2:
Mailing Address - City:FT WALTON BCH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-5833
Mailing Address - Country:US
Mailing Address - Phone:850-983-8447
Mailing Address - Fax:850-983-8148
Practice Address - Street 1:255 MIRACLE STRIP PKWY SE UNIT B14
Practice Address - Street 2:
Practice Address - City:FT WALTON BCH
Practice Address - State:FL
Practice Address - Zip Code:32548-5833
Practice Address - Country:US
Practice Address - Phone:850-983-8447
Practice Address - Fax:850-983-8148
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS3912235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist