Provider Demographics
NPI:1689943805
Name:NGUYEN, VU MINH (LIC ACUPUNCTURE)
Entity Type:Individual
Prefix:
First Name:VU
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:LIC ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9845 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6100
Mailing Address - Country:US
Mailing Address - Phone:954-239-3628
Mailing Address - Fax:954-239-3629
Practice Address - Street 1:9845 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6100
Practice Address - Country:US
Practice Address - Phone:954-239-3628
Practice Address - Fax:954-239-3629
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2187171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist