Provider Demographics
NPI:1760019335
Name:NGO, KEVIN (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:NGO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4700 MILLENIA BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:725-228-4520
Mailing Address - Fax:877-889-5390
Practice Address - Street 1:6360 BOULDER HWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-7301
Practice Address - Country:US
Practice Address - Phone:725-228-4520
Practice Address - Fax:778-895-3908
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2023-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVDO3237207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine