Provider Demographics
NPI:1669618914
Name:LAM, MINH DAI (ARNP)
Entity type:Individual
Prefix:MR
First Name:MINH DAI
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N FLAGLER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3429
Mailing Address - Country:US
Mailing Address - Phone:561-279-2665
Mailing Address - Fax:
Practice Address - Street 1:23123 STATE ROAD 7 STE 108
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-5489
Practice Address - Country:US
Practice Address - Phone:561-279-2665
Practice Address - Fax:561-439-2665
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9177293363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner