Provider Demographics
NPI:1649346230
Name:DO, NATHAN MINH (MD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:MINH
Last Name:DO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16223 NOTTINGHAM PARK WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2769
Mailing Address - Country:US
Mailing Address - Phone:813-773-6658
Mailing Address - Fax:
Practice Address - Street 1:401 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5710
Practice Address - Country:US
Practice Address - Phone:813-467-4725
Practice Address - Fax:813-412-5232
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2024-09-30
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Provider Licenses
StateLicense IDTaxonomies
FLME 96749207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000944100Medicaid
FL000944100Medicaid
FLCB914W- PASCOMedicare PIN