Provider Demographics
NPI:1265421770
Name:TRAN, TRUC CHINH (MD)
Entity type:Individual
Prefix:DR
First Name:TRUC
Middle Name:CHINH
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1175 SPRING CENTRE SOUTH BLVD STE 1020
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-5000
Mailing Address - Country:US
Mailing Address - Phone:321-221-8522
Mailing Address - Fax:407-297-9801
Practice Address - Street 1:1175 SPRING CENTRE SOUTH BLVD STE 1020
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5000
Practice Address - Country:US
Practice Address - Phone:321-221-8522
Practice Address - Fax:407-297-9801
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME38008208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067886400Medicaid