Provider Demographics
NPI:1083456438
Name:TRAN, TRICIA VU
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:VU
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PATRICIA AVE
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-8100
Mailing Address - Country:US
Mailing Address - Phone:727-331-8740
Mailing Address - Fax:727-331-8744
Practice Address - Street 1:125 PATRICIA AVE
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-8100
Practice Address - Country:US
Practice Address - Phone:727-331-8740
Practice Address - Fax:727-331-8744
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC9119007207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine