Provider Demographics
NPI:1093974776
Name:TRAN, NANCY MY NGOC (MD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MY NGOC
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 N FLAMINGO RD STE 265
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1013
Mailing Address - Country:US
Mailing Address - Phone:954-986-9008
Mailing Address - Fax:954-986-6646
Practice Address - Street 1:603 N FLAMINGO RD STE 265
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1013
Practice Address - Country:US
Practice Address - Phone:954-986-9008
Practice Address - Fax:954-986-6646
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117522207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016381100Medicaid