Provider Demographics
NPI:1700178910
Name:LE, BRUCE GIANG (DO)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:GIANG
Last Name:LE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8425 NORTHCLIFFE BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1107
Mailing Address - Country:US
Mailing Address - Phone:405-757-5490
Mailing Address - Fax:
Practice Address - Street 1:8425 NORTHCLIFFE BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1107
Practice Address - Country:US
Practice Address - Phone:405-757-5490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12794207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine