Provider Demographics
NPI:1932454865
Name:BUI, TRUNG (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TRUNG
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8145 TROXLER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3517
Mailing Address - Country:US
Mailing Address - Phone:203-500-6680
Mailing Address - Fax:
Practice Address - Street 1:5575 S SEMORAN BLVD
Practice Address - Street 2:SUITE 39
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1747
Practice Address - Country:US
Practice Address - Phone:407-281-0228
Practice Address - Fax:407-281-0229
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27564225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist