Provider Demographics
NPI:1669452983
Name:NGUYEN, HOA N (MD)
Entity Type:Individual
Prefix:
First Name:HOA
Middle Name:N
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 SHERIDAN ST STE 470
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3437
Mailing Address - Country:US
Mailing Address - Phone:954-986-6667
Mailing Address - Fax:954-983-6665
Practice Address - Street 1:4651 SHERIDAN ST STE 470
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3437
Practice Address - Country:US
Practice Address - Phone:954-986-6667
Practice Address - Fax:954-983-6665
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME508212086X0206X, 208800000X, 2088F0040X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024629400Medicaid
FL03948OtherBCBS OF FL
FL03948OtherBCBS OF FL
FL03948VMedicare PIN