Provider Demographics
NPI:1922069533
Name:NGUYEN, QUAN ANH (DO)
Entity Type:Individual
Prefix:DR
First Name:QUAN
Middle Name:ANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:350 MAITLAND AVE
Mailing Address - Street 2:STE 1001
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5400
Mailing Address - Country:US
Mailing Address - Phone:407-339-7682
Mailing Address - Fax:407-339-7690
Practice Address - Street 1:350 MAITLAND AVE
Practice Address - Street 2:STE 1001
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-339-7682
Practice Address - Fax:407-339-7690
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9247207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48126OtherBCBS
FLP00187130OtherRAIL ROAD MEDICARE
FL270224000Medicaid
FL295520OtherAVMED
FL270224000Medicaid
FL295520OtherAVMED