Provider Demographics
NPI:1013118199
Name:NGUYEN-SPERRY, JANET LE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:LE
Last Name:NGUYEN-SPERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:LE
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:12993 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9215
Practice Address - Country:US
Practice Address - Phone:561-784-9008
Practice Address - Fax:561-784-0905
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN6661390200000X
FLME1016092085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP0016302OtherFLORIDA HEALTHCARE PLUS
FL9948277OtherAETNA
FLP941168OtherOPTIMUM
FL0002537-00Medicaid
FL7059045OtherCIGNA
FLP01669000OtherRR MEDICARE
FLQMP000003701324OtherMOLINA HEALTHCARE
FL52574OtherBCBS OF FL
FL755812OtherWELLCARE
FLP01184511OtherRAILROAD MCR
FLF00298101305OtherUNITED HEALTHCARE
FL13343OtherDIMENSIONS HEALTH
FL27368OtherMEDICA
FLP999800OtherFREEDOM HEALTH
FL000253700Medicaid
FL323494OtherAVMED
FLP305100Medicaid
FLF00298101305OtherUNITED HEALTHCARE
FL000253700Medicaid
FL0002537-00Medicaid